RSA-227 - Annual Client Assistance Program (CAP) Report

Alaska (ASIST, INC.) - H161A110061 - FY2011

General Information

Designated Agency Identification

NameDepartment of Education and Early Development
Address801 West 10th Street Suite 200
Address Line 2
CityJuneau
StateAlaska
Zip Code99801
E-mail Address
Website Address
Phone907-465-2875
TTY
Toll-free Phone
Toll-free TTY
Fax907-465-2110

Operating Agency (if different from Designated Agency)

NameASIST, Inc.
Address2900 Boniface Parkway, Suite 100
Address Line 2
CityAnchorage
Zip Code99504
E-mail Addressakcap@alaska.com
Website Addresshttp://home.gci.net/alaskacap/
Phone907-333-2211
TTY907-333-2211
Toll-free Phone800-478-0047
Toll-free TTY800-478-0047
Fax907-333-1186

Additional Information

Name of CAP Director/CoordinatorPam Stratton
Person to contact regarding reportPam Stratton
Contact Person Phone907-250-4244

Part I. Agency Workload Data

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the Rehabilitation Act253
2. Information regarding Title I of the ADA7
3. Other information provided107
4. Total I&R services provided (Lines A1+A2+A3)367
5. Individuals attending trainings by CAP staff (approximate)341

B. Individuals served

An individual is counted only once during a fiscal year. Multiple counts are not permitted for Lines B1-B3.

1. Individuals who are still being served as of October 1 (carryover from prior year)29
2. Additional individuals who were served during the year37
3. Total individuals served (Lines B1+B2)66
4. Individuals (from Line B3) who had multiple case files opened/closed this year. (In unusual situations, an individual may have more than one case file opened/closed during a fiscal year. This number is not added to the total in Line B3 above.)2

C. Individual still being served as of September 30

Carryover to next year. This total may not exceed Line I.B3. 17

D. Reasons for closing individuals' case files

Choose one primary reason for closing each case file. There may be more case files than the total number of individuals served to account for those unusual situations, referred to in Line I.B4, when an individual had multiple case files closed during the year.

1. All issues resolved in individual's favor19
2. Some issues resolved in individual's favor (when there are multiple issues)13
3. CAP determines VR agency position/decision was appropriate for the individual3
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)0
5. Individual chose alternative representation2
6. Individual decided not to pursue resolution2
7. Appeals were unsuccessful0
8. CAP services not needed due to individual's death, relocation, etc.0
9. Individual refused to cooperate with CAP10
10. CAP unable to take case due to lack of resources0
11. Other (please explain)

E. Results achieved for individuals

1. Controlling law/policy explained to individual13
2. Application for services completed.3
3. Eligibility determination expedited0
4. Individual participated in evaluation0
5. IPE developed/implemented8
6. Communication re-established between individual and other party13
7. Individual assigned to new counselor/office10
8. Alternative resources identified for individual2
9. ADA/504/EEO/OCR/ complaint made0
10. Other0
11. Other (please explain)

Part II. Program Data

A. Age

As of the beginning of the fiscal year. Multiple responses are not permitted.

1. 21 and under3
2. 22 - 4017
3. 41 - 6445
4. 65 and over1
5. Total (Sum of Lines A1 through A4. Total must equal Line I.B3.)66

B. Gender

Multiple responses not permitted.

1. Female29
2. Male37
3. Total (Sum of Lines B1 and B2. Total must equal Line I.B3.)66

C. Race/ethnicity

1. Hispanic/Latino of any race4
For individuals who are non-Hispanic/Latino only
2. American Indian or Alaskan Native13
3. Asian1
4. Black or African American6
5. Native Hawaiian or Other Pacific Islander0
6. White42
7. Two or more races0
8. Race/ethnicity unknown0

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Blindness (both eyes)2
2. Other visual impairments2
3. Deafness1
4. Hard of hearing1
5. Deaf-blind0
6. Orthopedic impairments13
7. Absense of extremities1
8. Mental illness14
9. Substance abuse (alcohol or drugs)6
10. Mental retardation0
11. Specific learning disabilities (SLD)7
12. Neurological disorders4
13. Respiratory disorders0
14. Heart and other circulatory conditions3
15. Digestive disorders0
16. Genitourinary conditions0
17. Speech Impairments0
18. AIDS/HIV positive0
19. Traumatic brain injury (TBI)1
20. All other disabilities11
21. Disabilities not known0
22. Total (Sum of Lines D1 through D21. Total must equal Line I. B3.)66

E. Types of individuals served

Multiple responses permitted.

1. Applicants of VR Program23
2. Clients of VR Program42
3. Applicants or clients of IL Program1
4. Applicants or clients of other programs and projects funded under the Act6

F. Source of individual's concern

Multiple responses permitted.

1. VR agency only56
2. Other Rehabilitation Act sources only1
3. Both VR agency and other Rehabilitation Act sources9
4. Employer2

G. Problem areas

Multiple responses permitted.

1. Individual requests information62
2. Communication problems between individual and counselor59
3. Conflict about services to be provided42
4. Related to application/eligibility process23
5. Related to IPE development/implementation42
6. Other Rehabilitation Act-related problems5
7. Non-Rehabilitation Act related1
8. Related to Title I of the ADA0

H. Types of CAP services provided

Choose one primary CAP service provided for each case file/service record.

1. Information/referral0
2. Advisory/interpretational15
3. Negotiation31
4. Administrative/informal review2
5. Alternative dispute resolution0
6. Formal appeal/fair hearing0
7. Legal remedy0
8. Transportation0

Part III. Narrative

Narrative

ALASKA CLIENT ASSISTANCE PROGRAM FY11 FINAL REPORT

Fiscal year 2011 was the twenty-first year of operation of the Alaska Client Assistance Program by ASIST, Inc. This section of the final report will summarize the program operations for the year, following the outline format suggested in the instructions for Form RSA-227.

A. Type of agency used to administer CAP: In Alaska, the type of agency used to administer the CAP would be classified as External — other public agency. The Department of Education and Early Development is the designated agency to administer the CAP. They have had an on-going contract with ASIST, Inc. (a private vendor) as the operating agency. This has been the last year of the contract and the owner of ASIST, Inc. is retiring and closing the business. The new contracting agency will be the Disability Law Center of Alaska.

B. Source of funds expended: In Alaska, the CAP’s expenditures are funded solely by Federal funds.

Source of funding Total expenditures spent on individuals

Federal Funds $124439 State Funds $ 0 All Other Funds $ 0 TOTAL $124439

C. Budget for current and following fiscal years: No "following" fiscal year included since ASIST, Inc. will not be continuing as the CAP contractor.

ALASKA CLIENT ASSISTANCE PROGRAM BUDGET for FY11

Category FY11 (Actual Expenditures) Personnel: for 1.44 person-years Staff $69216.87 Taxes/Wkrs’ Comp $ 7987.51 Fringe Benefits $ 3316.26 TOTEL $ 80520.64

Category FY11 (Actual Expenditures) Travel Airfare $ 2186.67 Per Diem $ 6185.67 Ground Travel Expenses $ 2165.00 TOTAL $ 10537.34

Contractual Bank Fees $ 88.42 Bookkeeping Services $ 660.00 Brochures $ 0 Computer Consultant $ 112.00 CPA Services $ 4150.00 Interpreter Services $ 0 Legal Services $ 0 Liability Insurance $ 327.96 Memberships/Licenses $ 669.06 Mileage $ 1290.88 Postage $ 301.70 Rent $ 2100.00 Taxes $ 2760.00 Telephone $ 4771.20 Training/Conference fees $ 653.70 TOTAL $ 17884.92

Materials and Supplies Computer & Software $ 1069.00 Copying $ 50.66 Office Furnishings $ 698.63 Office Supplies $ 1407.03 TOTAL $ 3225.32

TOTAL EXPENSES $112168.22*

*Final budget for FY11 pending submission of final billings, review, and audit which may result in some change.

D. The number of person-years:

Type of Position Full-time % of year Person-year Equivalent PROFESSIONAL Director (Anch./statewide) 1 100% 1 Administrative Assistant 0.03 100% 0.03 Ketchikan Regional Rep. 0.04 100% 0.04 Juneau Regional Rep. 0.08 100% 0.08 Fairbanks Regional Rep. 0.08 100% 0.08 Clerical 0.21 100% 0.21

The Alaska CAP has had a unique arrangement with their staff that allowed them to provide statewide coverage, with a number of Regional Representatives, yet not spend an inordinate amount on overhead (ie. office rent). Our staffing arrangement provided for 1 full time employee in Anchorage, with the rest of the staff working in their regions on an “as needed” basis. This applied to the Administrative Asst. and Clerical position as well, which were located in Anchorage. The Regional Representatives responded to I & R requests, provided individual assistance services, and did outreach in their communities. As the demand for CAP services was somewhat sporadic, it would have been difficult to justify a position with set hours. By working on an “as needed” basis the hours could be allocated wherever the need was identified. The agency provided a phone and P.O. box for each location; the staff worked out of their homes; and met with individuals in public locations (ie. libraries, schools, restaurants, etc.), which were accessible.

As the positions were for minimal employment, it was sometimes difficult to identify and recruit an appropriate individual for all the potential sites. We were pleased that our Fairbanks, Juneau, and Ketchikan staff members have been with ASIST, Inc. for 6 yrs, 17 yrs, and 14 yrs. respectively. If the Alaska CAP budget were to receive an increase from Congress, it would have been able to hire another full time CAP staff member in the Anchorage office, and place more staff in communities around the state. These additional staff positions would have increased our outreach services and expanded the number of individuals that we would have been able to serve.

E. Summary of presentations made: The majority of presentations made by the CAP staff involved delivering information about the CAP, the State and Tribal Vocational Rehabilitation Programs, and the Independent Living Centers. The CAP staff made presentations to the following groups around the state: community providers and consumers of mental health services; members of a TBI Support group; staff at SEARHC health services; staff at a Community Rehabilitation Program; staff members at an ILC; the State Vocational Rehabilitation Committee; staff of a number of social service agencies for senior citizens and individuals with disabilities; Career Academy staff; American Council of the Blind-Alaska Chapter Convention; and, DVR staff. There were approximately 341 persons who attended these presentations. Again, with additional funding we would have been able to hire the staff necessary to reach out to more organizations and individuals.

F. Involvement with advisory boards: The Director of the CAP has been a member of the State Vocational Rehabilitation Committee. This is the identified body for the state of Alaska that carries out the responsibilities of both the State Rehabilitation Council and the Assistive Technology Advisory Council. As a member of this Committee, the CAP Director served as the Chair of the Evaluation Sub-Committee, and the Fairbanks Rep. served as a member of the Assistive Technologies Subcommittee. In addition, the CAP Director has, for a number of years, been a signing member of the Tribal Vocational Rehabilitation Consortium and State Vocational Rehabilitation Agencies’ Interagency Agreement; and is a member of the Steering Committee for the National Coalition of State Rehabilitation Councils. In addition the CAP Regional Rep. from Fairbanks served on the statewide Alaska Mobility Coalition; and the CAP Regional Representative Ketchikan has served as: President of NAMI Ketchikan; a member of the Gateway Center for Human Services Advisory Board; a member of the NDRN CAP Committee; and a member of the Creekside Meeting Center Board of Directors.

G. Outreach to unserved/underserved populations: The CAP has sought to provide outreach to underserved and non-served individuals through: mailing out our brocheres to the Native Health Clinics in most western Alaskan villages; our participation in the Tribal and State Vocational Rehabilitation Agencies training and being a signing member of the Interagency Agreement; our presentations to the community providers for Senior Citizens and Individuals with Disabilities; and, staff of the Native Alaskan VR Programs.

The Alaska CAP has been very busy providing quality services to all the individuals requesting services from the CAP. Therefore, the CAP staff is restricted in the amount of outreach it has been able to perform. With additional funding for more staff, the CAP would have been able to devote more time and energy to outreach around the state. Whenever the CAP staff has increased outreach activities, there has been a corresponding increase in the request for CAP services.

H. Alternative Dispute Resolutions: The Alaska state DVR’s policy on appeals offers individuals an opportunity to request a less formal Administrative Review prior to Alternative Dispute Resolution (ADR) or a Fair Hearing. The Administrative Review is conducted by someone at the administrative level that has not had any contact with the individual’s case up to that point and is to be completed within 15 days of the request. During FY11, the CAP assisted 2 consumers of DVR with their requests for an Administrative Review which were resolved to the individuals’ satisfaction prior to the Admin. Review. Three additional Administrative Review were requested and held. One individual went on to request a Fair Hearing, which was held also. All individuals were informed of their right to request ADR or a Fair Hearing prior to the Administrative Reviews. To briefly summerize the issues and outcomes of these appeals, they will be listed in the order in which they occurred.

1. Administrative Review requested by an individual from the Anchorage Downtown Office because she had asked her DVR counselor to add two services to her Amended Plan. Her counselor had not responded to this request. The requested services were:

- Pay travel costs for her two children to accompany her and her husband when they travel to Seattle for van modification services; and, - Pay for an iPad to serve as assistive technology device, for note taking in her meetings with DVR, doctors, and at work.

The Administrative Reviewer’s decision was to deny the first requested service and remove other services from her Plan so her husband could stay home to care for the children. He also determined that prior to DVR agreeing to purchase the iPad, the individual should request it as an accommodation from her employer. If she receives the denial in writing, she should revisit the issue with her DVR counselor.

2. Fair Hearing requested following an Administrative Review decision with which the individual did not agree. Her issues were the decisions made in the Administrative Review above. The Impartial Hearing Officer found that DVR had not gathered enough data to determine which services were truly “needed” and the comparative costs of providing those services through one manner or another. DVR was directed to collect that information and for the individual to have an evaluation to determine her needs for Personal Care Assistance. Once that data was collected, the IHO directed that the individual and her counselor should set down to work out the options and costs so the individual could be involved in making an informed choice.

3. Administrative Review requested by an individual from the Southeast Regional office when DVR closed her application for services as too disabled to benefit from services without allowing her to participate in either Trial Work or Extended Evaluation.

The Administrative Reviewer found that the “case should be re-opened so the client is afforded the opportunity for trial work.”

4. Administrative Review requested by an individual, and his guardian, from the Debarr-Eagle River Regional office when DVR closed his application for services as too disabled to benefit from services after only one Trial Work experience.

The Administrative Reviewer determined that the individual had had an appropriate opportunity to determine it he was capable of benefiting from DVR’s services in terms of achieving an employment outcome and that his case should remain closed.

I. Systemic Advocacy: During the course of delivering CAP services, we identified five issues that, in our judgment, represent system-wide barriers to the receipt of services from DVR, Tribal VR, and/or Independent Living Centers. Each is discussed below.

1. Case closures with no contact and/or discussion between DVR counselor and individual prior to closure letter being sent. This has been a recurring issue; in fact, it was identified in FY10, FY08, and FY06. Over the past 9 months, the CAP has had complaints about this issue from individuals being served in 6 of the 10 DVR offices around the state.

The individuals who contacted the CAP were dismayed, angry, confused, and unhappy to have received a closure letter unexpectedly. The CAP informed the individuals of their rights to appeal the closure, starting with talking with their counselor and/or the counselor’s supervisor. The CAP also offered assistance if they felt a need for support. Some individuals said they felt they could handle it on their own, and a few even called back to let the CAP know that things had worked out to their satisfaction. Others chose to apply to the CAP for assistance.

The CAP knows that DVR has provided in-service trainings over the years to discuss the case closure process so that it is done in a legal, professional, and ethical manner. And yet, it continues to happen. Unfortunately, these types of actions do get shared by unhappy individuals and harms DVR’s image within the disability community, and among other agencies.

2. Unreturned voicemails and/or emails are an on-going source of frustration for individuals working with DVR. Not just applicants and clients of DVR but also other agencies and venders have voiced this complaint. Some of the time, it happens because the DVR staff person is out of the office and has not changed their voicemail/email message. Or, the staff member is out unexpectedly and no one else assumes responsibility to change the message. Knowing why someone is not responding can help alleviate much of the frustration, helps to develop trust and understanding, and gives one the opportunity to make other choices. Most staff who work a flex schedule don’t seem to put that on their message, so instead of 48 hours to respond, it might actually be 72 hours or longer, or never.

When the CAP receives this type of report, either from an individual who is trying to work with DVR and just needs to vent, or from someone who is a CAP client, we do ask if this has happened over a period of days/weeks/months? Or were these 3 messages left today? We suggest that after leaving a message with the counselor, that the counselor’s assistant be contacted and a message left there, or inquiry made as to when the counselor may be available to respond. If there have been multiple unanswered messages over a period of time, the CAP suggests that an email is sent to the counselor and “cc’d” to the manager of that office. If the individual happens to be a CAP client, then the CAP would ask that it would also be “cc’d” and would follow up with the counselor/manager as well.

3. At least two Regional DVR Offices have recently had appeals requested due to a decision to close their applications either without any Trial Work or Extended Evaluation activities or after just one Trial Work experience. The CAP is concerned that DVR staff are denying these individuals the opportunity to demonstrate whether they could work or not when all necessary supports are in place. And, DVR has not established “clear and convincing” evidence to support their decision. In both cases there was a lack of discussion about necessary supports that the individual could benefit from in order to be successful.

The CAP would suggest some in-service training for all staff on their responsibilities in developing Trial Work/Extended Evaluation experiences.

4. The DVR’s orientation video, which is required viewing for all potential applicants, provides inadequate information regarding the vocational rehabilitation process. This was discussed with the DVR administration in January, 2011, and the CAP was informed that they recognized and agreed that it was incomplete. The DVR informed the CAP that they were working on a companion video that would present a much more informative and complete description of the entire VR process, including information regarding the Client Assistance program. This has not happened to date, and again the CAP was told that it was in the process of being completed.

Since this video is required viewing, and the first contact with the DVR that individuals have, the CAP would presume that DVR has a vested interest in providing the most complete explanation of the whole process in as interesting and thorough a manner as possible. The CAP would urge that this project be given priority to be completed in a timely manner.

5. The CAP has received questions, concerns, and complaints from individuals who are applicants to the Independent Living Center, Access Alaska that serves Anchorage and Wasilla. Individuals report that they have attempted to apply for services and have had their application ignored; have been told that they filled out the wrong application; or, they were left with forms that only gave them the option for applying if they agreed that they did not want a written plan for the services they felt they needed.

When the CAP requested the opportunity to review the application forms, it discovered that if an individual was applying for services for which there was a cost involved, then one had to know which kind of application form to request as not all services were available from the same application form. Also, another form spoke to an individual having the option of deciding whether or not they wanted to have a written Plan. While that is great information for applicants to receive, the form is poorly worded and confusing as to its intent. Many felt that there was no way to make a choice to have a written Plan for services.

The CAP would strongly suggest that Access Alaska review their application forms and simplify the process, which will mean they will need to provide thorough staff training on how to explain/present the new forms to applicants. An individual who wants to apply for IL services should not need to know in advance exactly what services they need and have to ask for the application form that provides those services. J. Typical Cases The following two cases are representative of typical situations that individuals, who contact the CAP, confront in their attempt to receive needed services through the state Division of Vocational Rehabilitation:

1. An individual had been found eligible and his counselor had agreed with his vocational goal as it built on his current transferable skills and interests. They wrote an IPE that provided the services he needed to become successfully employed, and then the Regional Manager denied the Plan. The Regional Manager questioned the vocational goal, as he believed that it was incompatible with the individual’s disability. At the recommendation of the VR counselor, the individual contacted the CAP and applied for services.

The CAP had a discussion with the counselor, who shared his rational for approving the vocational goal. The CAP talked to the Manager, who explained his questions and concerns and what documentation he wanted to see to convince him that it was an appropriate goal. The CAP shared this info with the counselor and client who agreed to better document the information they had already reviewed. Once that documentation reached the Manager, he agreed that the goal was appropriate and approved the Plan.

2. An individual with mental health issues applied for DVR services and ran into communication issues with his counselor. He is a large individual and has some anger and trust issues. His counselor stated she did not feel safe meeting with him. He contacted the CAP and applied for services. The CAP explained the DVR process and service. The individual stated that he just wanted a fair opportunity to be found eligible.

The CAP contacted the counselor who agreed to meet with the CAP and the individual to discuss the Trial Work process. The CAP explained the Trial Work process again with the individual who agreed to the meeting also. We met, the counselor explained that she wanted him to participate in Trial Work and introduced him to the VR staff member who would be working with him to identify and set up a Trial Work site. The individual was happy with the Trial Work Plan and VR agreed to move forward.

K. On-line information/outreach: The Alaska CAP has a web page at http://home.gci.net/alaskacap/. This past year there were 1621 visits to the site. The site offers links to Alaska DVR, the state SILC website, the Rehabilitation Act of 1973, and Title I of the ADA.

Certification

Approved

This Report is Complete and Correct.Yes
Date Signed:08-Oct-11
Name of Designated Agency Official:Anna Kim
Title of Designated Agency Official:Administrative Services Director AK DEED