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

Maryland (MARYLAND DIVISION OF REHAB SERVICES -- CLIENT ASSISTANCE PROGRAM) - H161A110021 - FY2011

General Information

Designated Agency Identification

NameMaryland Division of Rehabilitation Services -DORS
Address2301 Argonne DR
Address Line 2
CityBaltimore
StateMaryland
Zip Code21218
E-mail Addresscap@dors.state.md.us
Website Addresshttp://www.dors.state.md.us
Phone(410)554-9361
TTY
Toll-free Phone1-800-638-6243
Toll-free TTY1-800-638-6243
Fax410-554-9362

Operating Agency (if different from Designated Agency)

NameMaryland Division of Rehabilitation Services -DORS
Address2301 Argonne DR
Address Line 2
CityBaltimore
Zip Code21218
E-mail Addresscap@dors.state.md.us
Website Addresshttp://www.dors.state.md.us
Phone(410)554-9361
TTY
Toll-free Phone1-800-638-6243
Toll-free TTY1-800-638-6243
Fax410-554-9362

Additional Information

Name of CAP Director/CoordinatorThomas Laverty
Person to contact regarding reportThomas Laverty
Contact Person Phone410-554-9363

Part I. Agency Workload Data

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the Rehabilitation Act210
2. Information regarding Title I of the ADA4
3. Other information provided70
4. Total I&R services provided (Lines A1+A2+A3)284
5. Individuals attending trainings by CAP staff (approximate)0

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)39
2. Additional individuals who were served during the year105
3. Total individuals served (Lines B1+B2)144
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.)0

C. Individual still being served as of September 30

Carryover to next year. This total may not exceed Line I.B3. 32

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 favor89
2. Some issues resolved in individual's favor (when there are multiple issues)4
3. CAP determines VR agency position/decision was appropriate for the individual6
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)0
5. Individual chose alternative representation1
6. Individual decided not to pursue resolution6
7. Appeals were unsuccessful1
8. CAP services not needed due to individual's death, relocation, etc.0
9. Individual refused to cooperate with CAP5
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 individual18
2. Application for services completed.6
3. Eligibility determination expedited3
4. Individual participated in evaluation4
5. IPE developed/implemented44
6. Communication re-established between individual and other party25
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 under18
2. 22 - 4044
3. 41 - 6479
4. 65 and over3
5. Total (Sum of Lines A1 through A4. Total must equal Line I.B3.)144

B. Gender

Multiple responses not permitted.

1. Female73
2. Male71
3. Total (Sum of Lines B1 and B2. Total must equal Line I.B3.)144

C. Race/ethnicity

1. Hispanic/Latino of any race3
For individuals who are non-Hispanic/Latino only
2. American Indian or Alaskan Native1
3. Asian1
4. Black or African American82
5. Native Hawaiian or Other Pacific Islander0
6. White54
7. Two or more races0
8. Race/ethnicity unknown3

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Blindness (both eyes)8
2. Other visual impairments3
3. Deafness15
4. Hard of hearing5
5. Deaf-blind2
6. Orthopedic impairments16
7. Absense of extremities2
8. Mental illness53
9. Substance abuse (alcohol or drugs)0
10. Mental retardation4
11. Specific learning disabilities (SLD)19
12. Neurological disorders9
13. Respiratory disorders0
14. Heart and other circulatory conditions0
15. Digestive disorders0
16. Genitourinary conditions0
17. Speech Impairments0
18. AIDS/HIV positive1
19. Traumatic brain injury (TBI)5
20. All other disabilities2
21. Disabilities not known0
22. Total (Sum of Lines D1 through D21. Total must equal Line I. B3.)144

E. Types of individuals served

Multiple responses permitted.

1. Applicants of VR Program20
2. Clients of VR Program122
3. Applicants or clients of IL Program2
4. Applicants or clients of other programs and projects funded under the Act0

F. Source of individual's concern

Multiple responses permitted.

1. VR agency only138
2. Other Rehabilitation Act sources only1
3. Both VR agency and other Rehabilitation Act sources5
4. Employer0

G. Problem areas

Multiple responses permitted.

1. Individual requests information0
2. Communication problems between individual and counselor20
3. Conflict about services to be provided9
4. Related to application/eligibility process35
5. Related to IPE development/implementation78
6. Other Rehabilitation Act-related problems2
7. Non-Rehabilitation Act related0
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/interpretational22
3. Negotiation64
4. Administrative/informal review18
5. Alternative dispute resolution2
6. Formal appeal/fair hearing4
7. Legal remedy2
8. Transportation0

Part III. Narrative

Narrative

B. Sources of funds

Sources of Funds Expended

The information detailed in this section and the next was provided by the Division of Rehabilitation Services (DORS) Branch Chief for Fiscal Operations.

FEDERAL FISCAL YEAR 2011 SOURCE OF FUNDING TOTAL EXPENDITURES SPENT ON INDIVIDUALS Federal Funds 183,906 State Funds 0 All Other Funds 0 Total from all sources 183,906 C. Budget for Current and Following Fiscal Years

The CAP budget detailed in Section II C reflects the application of funds expected to be received from the federal formula grants.

CATEGORY STATE FISCAL ‘12 STATE FISCAL ‘13 WAGES & SALARIES 115,839 98,697

FRINGE BENEFITS - FICA, UNEMPLOYMENT, ETC. 50,781 49,626 MATERIALS/SUPPLIES 0 3,004 POSTAGE -0- -0- TELEPHONE -0- 1,000 RENT -0- -0- TRAVEL 5,349 8,237 COPYING 0 5,000 BONDING/INSURANCE 48 92 EQUIPMENT RENTAL/PURCHASE 0 1,040 LEGAL SERVICES 3,167 4,316 INDIRECT COSTS 0 0 MISCELLANEOUS* (includes interpreter services) 738 6,248 TOTAL BUDGET 175,922 177,260

D. Person - Years Professional:

There was one (1.06) full-time, permanent, professional position dedicated to delivery of CAP services during FY 2010. The CAP Director’s position changed from acting to permanent on May 4, 2011. A new CAP employee started for the program on September 9, 2011.

Total Professional Person Years: 1.06

Clerical:

CAP received no clerical support during FY 2011.

Total Professional and Clerical Person Years: 1.06

E. Summary of Presentations Nine (9) information and outreach efforts were made regarding CAP and other rehabilitation programs and projects during FY 2011, reaching approximately 242 individuals. Attendees included a diverse mixture of individuals with disabilities, family members, rehabilitation professionals, and other interested parties. CAP attended all 5 of the VR Public meetings and discussed CAP services. Approximately 112 individuals were in the audience of these public meetings.

CAP attended the World of Possibilities Disability Expo to present information regarding the scope of VR and IL services, and the CAP program. Approximately 65 individuals spoke with CAP staff and received materials. CAP attended several meetings of the Statewide Independent Living Council, and the IL Partners meetings, as staff support to assist in the development and improvement in the SILC, and periodically discussed CAP information and provided advocacy related input. Approximately 15 individuals attended these meetings.

CAP attended the Montgomery County Transitioning Youth Resource Fair at Montgomery College — Rockville Campus. Information regarding services through the Client Assistance Program, the Division of Rehabilitation Services and the Centers for Independent Living was provided to approximately 40 individuals. CAP attended the MC Transition Group at the ARC of Montgomery County and presented information on the services available through the Division of Rehabilitation Services to individuals transitioning from school to work to approximately 10 individuals. Information on the Client Assistance Program and how it could help in the rehabilitation process was also provided.

F. Advisory Boards The CAP Director has an active role on the Maryland State Rehabilitation Council (MSRC). The CAP Council member serves on two sub-committees, the Public Relations and Quality Assurance subcommittee, and the Policy and Planning subcommittee. The CAP Director is the Committee Chair of the MSRC Policy and Planning committee.

The CAP Director also serves on the DORS Policy Review Committee, where policy issues are examined and debated. This membership facilitates CAP input into the policy development process.

The CAP Director has regularly attended Statewide Independent Living Council (SILC) on an ad-hoc basis, for purpose of providing a consumer advocacy perspective regarding improvements into Maryland’s IL system.

G. Outreach to Un-served and Underserved Populations

CAP attended all scheduled MSILC meetings to provide outreach to IL consumers, applicants, and referral sources.

CAP attended all DORS Public Meetings for purposes of outreach to attendees. These meetings are attended by both stakeholders, and clients and families.

CAP attended World of Possibilities statewide disabilities fair to disseminate CAP, IL and VR information to interested attendees. This fair is attended by individuals with disabilities, family members, and stakeholders.

H. Alternative Dispute Resolution

Maximum efforts are consistently made by DORS and CAP staff to resolve concerns prior to conducting an appeal hearing at the Office of Administrative Hearings. Satisfactory resolution is often achieved through participation in Administrative Review with Regional Directors or other administrators in the DORS chain of command. Additionally, the CAP attorney when representing consumers makes maximum efforts to settle issues informally without the need for a hearing if possible. The CAP attorney provided representation in nine (9) appeal requests. One hearing was held at the Office of Administrative Hearings to resolve one of the appeal requests. This hearing resulted in the decision of the Division of Rehabilitation Services being upheld. The other eight appeal requests were resolved through informal administrative review, and were resolved both partially and fully in the client’s favor.

I. Systemic Advocacy

CAP has significant opportunity to advocate for consumers on a systemic level as a member of the Maryland State Rehabilitation Council, and through participation on the Division’s Policy Review Committee. Additionally, the CAP Director has frequent contact and ready access to all members of the DORS Executive leadership and administration for purposes of systemic advocacy. CAP participation on other committees listed in section F also allowed for CAP to have significant input into systemic advocacy issues. CAP systemic advocacy issues during FY 2011 included:

1. Maryland Division of Rehabilitation Services (DORS) funding and budget issues continued as the priority systemic advocacy issue for CAP in FY 2011. The waiting list for individuals who are classified as having a significant disability is currently approximately 13 month. The waiting list is expected to continue to grow, and longer delays are expected through FY 2012. At this point category 2 will open up periodically to waiting list individuals depending on staff capacity. The waiting list is now also a matter of human resource limitations, as well as budget, because of state government budget problems and hiring delays and restrictions for all state agencies.

2. CAP continues to work with the State Rehabilitation Council on the expansion of VR satisfaction surveys to include both web-based option and in-process data.

3. CAP continues to work on a possible VR funding issues for certain private career schools where there is no comparable program available at a public school or community college. An example of this is cosmetology training, which is not available in a public school, and costs and proximity vary from school to school. The VR agency agreed to review this under the Skills2Compete initiative, which is a state government initiative to increase the employment skill of Marylanders, thus increasing competitiveness.

Administrators are regularly attentive and responsive to systems issues identified by CAP, and CAP appreciates the level of participation in policy and program development afforded to CAP, as well as the serious consideration given to CAP suggestions and opinions.

J. Interesting Cases

1. CAP received information regarding a letter of appeal sent to the Division of Rehabilitation Services by a 21 year old male requesting continued funding to attend his college program. This individual did not have a current case with the Client Assistance Program so he was contacted by CAP and informed of the services available to him through the program.

In his explanation to CAP regarding his reasons for filing an appeal of the Division’s decision this individual stated that the Division had provided the funding he needed to attend the fall semester of college and now due to the low grades he had received for the semester DORS would not continue funding for the next semester. He indicated that his counselor had not helped him adequately understand what would be involved in his transition from attending a Community College to attending classes at a University. He did not feel he should be penalized because he did not know that he could receive help through the University’s disability support services when he began to have difficulties in class due to his learning disability.

The Client Assistance Program reviewed this individual’s record of services with the Division and contacted his vocational counselor regarding his concerns and his appeal of the Division’s funding denial. CAP also referred this individual to the CAP attorney for legal assistance.

The CAP attorney met with this individual to review his DORS case record and to discuss how he would like to proceed regarding his hearing request. They also reviewed how the issue of funding for school from the Division might be resolved without the need to go to a hearing. After a thorough review of the case information and the Division’s policy and procedures the CAP attorney approached the Division with several offers that would resolve the funding issue that was being appealed.

The individual that filed the appeal of the Division’s funding denial for school agreed to withdrawal their appeal. The Division agreed that if the individual completed their current semester with passing grades they would again provide funds for school. In addition to the funding that had been agreed to initially they would also provide funding for room and board at the University.

2. The Client Assistance Program received a call from a 34 year old deaf female who requested help in appealing the Division of Rehabilitation Services denial to assist her with attending Community College. This young woman explained that she has been receiving help from the Division to attend school. She has been able to complete several semesters successfully while taking a reduced number of credits. However, she had been advised that the Division would no longer provide these services to her unless she increased the number of credits she was taking to the number of credits needed to be considered a full time student.

The Client Assistance Program contacted her vocational counselor about her concerns and was advised by her counselor that the Division’s policy indicated that unless there was a justifiable reason for the individual to take a reduced number of credits then that individual would be required to be a full time student. This counselor also indicated that the client had been referred for a psychological evaluation but had not attended the scheduled assessment.

CAP asked that the counselor provide a copy of the existing diagnostic information that it had in the individual’s case record so it could be reviewed. CAP then contacted the Client and spoke with her about the information that had been provided by her vocational counselor regarding the Division’s need for diagnostic information justifying the need for her to take a reduced number of classes to be successful in school. The individual informed the Client Assistance Program that the Division had a copy of a neuropsychological evaluation that indicated the she needed to take a reduced number of college credits to be successful.

CAP reviewed the neuropsychological evaluation that DORS had as part of the Client’s case record. CAP believed that this report indicated that the limitation caused by previous neurological damage would be ongoing for this individual and result in the need for accommodations to be provided to her to attend college.

CAP contacted the individual’s vocational counselor about the information contained in the client’s existing neuropsychological evaluation and the need for the individual to be reevaluated to assess limitations. CAP suggested that the Division of Rehabilitation Services have this existing evaluation and its results reviewed by a psychologist that works with the agency to see if there would be new information gained by having the individual re-evaluated. The Division agreed to this course of action after much discussion.

This review of the existing diagnostic information resulted in the Division agreement that the individual needed accommodations in order to be successful in their college studies. One of these accommodations was the need to take a reduced number of credits per semester.

3.The Client Assistance Program received a request for help from an 18 year old male and his mother in asking the Division of Rehabilitation Services to transfer his case to a different vocational counselor and to provide him with the adaptive equipment he needed to complete a training program.

This individual explained that after applying for services from the Division of Rehabilitation Services he was referred for a number of diagnostic evaluations by his rehabilitation counselor. These evaluations included a psychological evaluation, an exploratory/career assessment, an adaptive driving assessment, an assistive technology assessment, and an occupational therapy pre driving assessment. These evaluations were to help him and his vocational counselor determine what type of employment he would like to pursue.

This individual and his vocational counselor developed an Individualized Plan for Employment following the completion of his eligibility for services through the Division and the numerous evaluations that he had been referred to. This plan had a vocational goal of Auto Mechanic Helper and included training to be completed at the Division of Rehabilitation’s Workforce and Technology Center. The Client stated that he had been waiting for some time for his vocational counselor to return his calls and inform him of when he would be able to begin his training. CAP contacted the vocational counselor about the clients concerns regarding training and his request to have his case transferred to a different counselor. The vocational counselor agreed to transfer the individual’s case to a different counselor but indicated that he would have to obtain his driver’s license before he could begin training at the Workforce and Technology Center.

CAP informed the client of the information obtained from the Division about his need for a driver’s license before he could begin his training program. The individual told CAP that he would need the adaptive computer equipment recommended in one of the evaluations that he completed so that he could read and understand written material in order to obtain his license.

CAP obtained and reviewed all of the client’s evaluations and contacted the Division about the individuals needed adaptive computer equipment. The Division informed the Client Assistance Program and the client they did not feel he needed this equipment and would not fund its purchase.

The Client Assistance Program spoke with the administrative staff of the Division of Rehabilitation Services regarding the individuals request for adaptive equipment but they would not change their decision. The client therefore asked that CAP help appeal the Division’s denial of this service.

CAP helped the individual complete and send an appeal letter asking for a hearing on the denial of adaptive computer equipment. The individual was referred to the CAP attorney so that he could prepare for the pre conference hearing and the hearing at the Maryland Office of Administrative Hearings.

The CAP attorney was able to reach an agreement with the Division of Rehabilitation Services after the Administrative Law Judge agreed that the case could go to hearing and a hearing date had been set. The agreement reached included the Division supplying this individual with the adaptive computer equipment and software recommended in the evaluation that had been completed by the client.

K. On-Line Information/Outreach

The Division’s Programs and the appeal process; self-advocacy tips; CAP staff role; as well as contact information including the address, voice and fax number, the toll-free number, and the email address. In addition, the CAP web link on the DORS home page is prominently displayed and easy to find, supports an Internet Web Page at http://www.dors.state.md.us with a link to several pages of CAP and appeals related information http://www.dors.state.md.us/DORS/ProgramServices/cap . The CAP pages give an overview of the Client Assistance Program

Certification

Approved

This Report is Complete and Correct.Yes
Date Signed:05-Dec-11
Name of Designated Agency Official:Thomas Laverty
Title of Designated Agency Official:Director, Client Assistance Program