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

Alaska (DISABILITY LAW CENTER OF ALASKA) - H161A120061 - FY2012

General Information

Designated Agency Identification

NameAlaska State Department of Education
Address
Address Line 2
City
StateAlaska
Zip Code
E-mail Address
Website Address
Phone
TTY
Toll-free Phone
Toll-free TTY
Fax

Operating Agency (if different from Designated Agency)

NameDisability Law Center of Alaska
Address3330 Arctic Blvd. 103
Address Line 2
CityAnchorage
Zip Code99503
E-mail Address
Website Addresshttp://www.dlcak.org
Phone907-565-1002
TTY907-565-1002
Toll-free Phone1-800-478-1234
Toll-free TTY1-800-478-1234
Fax907-565-1000

Additional Information

Name of CAP Director/Coordinator
Person to contact regarding report
Contact Person Phone

Part I. Agency Workload Data

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the Rehabilitation Act2
2. Information regarding Title I of the ADA0
3. Other information provided20
4. Total I&R services provided (Lines A1+A2+A3)22
5. Individuals attending trainings by CAP staff (approximate)112

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)0
2. Additional individuals who were served during the year35
3. Total individuals served (Lines B1+B2)35
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.)1

C. Individual still being served as of September 30

Carryover to next year. This total may not exceed Line I.B3. 10

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 favor4
2. Some issues resolved in individual's favor (when there are multiple issues)1
3. CAP determines VR agency position/decision was appropriate for the individual3
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)4
5. Individual chose alternative representation0
6. Individual decided not to pursue resolution3
7. Appeals were unsuccessful1
8. CAP services not needed due to individual's death, relocation, etc.1
9. Individual refused to cooperate with CAP3
10. CAP unable to take case due to lack of resources6
11. Other (please explain)

In the case of 5 clients: Case was transferred to the Alaska P&A when it became the Operating Agency, but client did not respond to attempts at contact. 1 client: After receiving initial request for assistance, client could no longer be reach/did not respond to attempts at contact.

E. Results achieved for individuals

1. Controlling law/policy explained to individual3
2. Application for services completed.0
3. Eligibility determination expedited0
4. Individual participated in evaluation1
5. IPE developed/implemented1
6. Communication re-established between individual and other party5
7. Individual assigned to new counselor/office1
8. Alternative resources identified for individual0
9. ADA/504/EEO/OCR/ complaint made0
10. Other15
11. Other (please explain)

3 clients: no outcome/Individual decided not to pursue resolution 9 clients: no outcome/client dropped out of contact with CAP 1 clients: no merit 1 client: no outcome/Client refused to cooperate 1 client: no outcome/client moved out of state

Part II. Program Data

A. Age

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

1. 21 and under1
2. 22 - 4012
3. 41 - 6422
4. 65 and over0
5. Total (Sum of Lines A1 through A4. Total must equal Line I.B3.)35

B. Gender

Multiple responses not permitted.

1. Female18
2. Male17
3. Total (Sum of Lines B1 and B2. Total must equal Line I.B3.)35

C. Race/ethnicity

1. Hispanic/Latino of any race1
For individuals who are non-Hispanic/Latino only
2. American Indian or Alaskan Native7
3. Asian1
4. Black or African American0
5. Native Hawaiian or Other Pacific Islander0
6. White24
7. Two or more races1
8. Race/ethnicity unknown1

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Blindness (both eyes)1
2. Other visual impairments0
3. Deafness1
4. Hard of hearing1
5. Deaf-blind1
6. Orthopedic impairments7
7. Absense of extremities1
8. Mental illness9
9. Substance abuse (alcohol or drugs)1
10. Mental retardation3
11. Specific learning disabilities (SLD)3
12. Neurological disorders1
13. Respiratory disorders0
14. Heart and other circulatory conditions2
15. Digestive disorders0
16. Genitourinary conditions0
17. Speech Impairments0
18. AIDS/HIV positive0
19. Traumatic brain injury (TBI)1
20. All other disabilities3
21. Disabilities not known0
22. Total (Sum of Lines D1 through D21. Total must equal Line I. B3.)35

E. Types of individuals served

Multiple responses permitted.

1. Applicants of VR Program7
2. Clients of VR Program28
3. Applicants or clients of IL Program0
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 only33
2. Other Rehabilitation Act sources only1
3. Both VR agency and other Rehabilitation Act sources1
4. Employer0

G. Problem areas

Multiple responses permitted.

1. Individual requests information0
2. Communication problems between individual and counselor7
3. Conflict about services to be provided15
4. Related to application/eligibility process4
5. Related to IPE development/implementation9
6. Other Rehabilitation Act-related problems1
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/interpretational23
3. Negotiation0
4. Administrative/informal review3
5. Alternative dispute resolution0
6. Formal appeal/fair hearing0
7. Legal remedy0
8. Transportation0

Part III. Narrative

Narrative

Note from Section B. As the Operating CAP Agency, the Alaska P&A files a quarterly report with the Designated CAP Agency, the State of Alaska Department of Education. Each quarter the P&A includes as part of that report a running tally of individuals served. Counting up the total of individuals served from each of the quarters, the total comes to 38 people. However, at the end of the year when we pulled a report from our database for CAP number of individuals served, the tally now shows as 35. The discrepancy is due to the shifting of clients into alternate funding sources as each case evolves and more appropriate categories become apparent.

DISABILITY LAW CENTER OF ALASKA CLIENT ASSISTANCE PROGRAM FY12 FINAL REPORT

Fiscal Year 2012 was the first year that the Alaska Client Assistance Program was operated by the Disability Law Center of Alaska, the Protection & Advocacy agency (P&A). 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 — Protection & Advocacy (P&A). The Department of Education and Early Development is the designated agency to administer the CAP. They have entered into this new contract with the Disability Law Center of Alaska, Inc. (P&A) as the operating agency. The Disability Law Center assumed responsibility for the Alaska CAP October 1, 2011.

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 $117,252.28 State Funds $0.00 All Other Funds $0.00 Total From All Sources $117,252.28

C. Budget for current and following fiscal years:

Category Current Fiscal Year Next Fiscal Year Salaries $52,350.00 $40,529.00 Fringe Benefits $22,473.00 $20,508.00 Materials/Supplies $1,675.00 $1,790.00 Postage $308.00 $247.00 Telephone $1,357.00 $1,482.00 Rent $8,121.00 $7,023.00 Travel $6,218.00 $1,729.00 Copying $1,542.00 $1,235.00 Bonding/Insurance $638.00 $544.00 Equipment Rental/Purchase $0.00 $0.00 Legal Services $200.00 $300.00 Indirect Costs $25,493.00 $19,879.00 Miscellaneous $4,313.00 $3,496.00 Total Budget $124,688.00 $98,762.00

D. The number of person-years:

Type of position Full-time equivalent % of year position filled Person-years Professional Full-time 1.11 100% 1.11 Part-time Vacant Clerical Full-time Part-time Vacant

The Alaska CAP utilizes a number of attorney and non-attorney advocates in three offices in the state to achieve statewide coverage. The P&A’s staffing arrangement provides for 1.11 full-time equivalent employees, with 5 employees in Anchorage (.87 FTE), 1 employee in Fairbanks (.20 FTE), and 1 employee in Juneau (.04 FTE). The advocates in Juneau and Fairbanks respond to I&R requests, provide individual advocacy assistance, and conduct outreach in their communities. In the Anchorage office, an Intake Specialist takes the initial call, obtains information and/or paperwork, and passes the matter on to the CAP advocates for assessment. Individuals seeking CAP services can do so by contacting any of the three offices or submit an email request. The Anchorage office also maintains a statewide toll-free 800 number for individuals outside of these three hub communities.

E. Summary of presentations made: The majority of presentations made by the CAP staff involved delivering information about the CAP to the State and Tribal Vocational Rehabilitation Program (DVR and TVR) managers and to the Executive Directors of Alaska’s Independent Living Centers (ILC) in October 2011. During that month, both the TVR and Alaska DVR managers were simultaneously conducting annual meetings in Anchorage, making these presentations both convenient for the Anchorage CAP advocates and timely since the P&A had just assumed operation of the CAP. The substance of the presentations included the introduction of the new CAP staff, how P&A CAP may operate differently from the prior CAP provider, and the additional services the P&A provides under its other grants and programs. CAP staff also had lunch with some of the newer counselors from the downtown DVR Anchorage office later that same month. Additionally, a CAP staff member is on the board of the Alaska Brian Injury Network (ABIN) and at its October meeting, provided information and the new CAP brochure to other board members and guests attending in Dillingham, Alaska.

A presentation about the P&A CAP and other P&A programs and services was made by CAP advocates at the Full Lives Conferences in Bethel and Anchorage. A CAP staff member that had provided most of the outreach and presentations throughout the state was able to introduce the new CAP program while providing training known as SSI/SSDI Outreach, Assess, and Recovery (SOAR). The first training on Joint Base Elmendorf-Richardson (JBER) in January 2012 was for a targeted audience of social work interns through the University of Anchorage Alaska (UAA) and Wounded Warrior Transition Unit staff (WT). This training came about by one of the WT staff who works on JBER helping soldiers transition from military life back to civilian life. These wounded warriors have been diagnosed with PTSD, TBI, physical disabilities or a combination of all three impairments or more. A percentage of exiting soldiers who want to work apply for DVR services and this is a great opportunity for them to become knowledgeable about resources in the community. This SOAR training was also provided in Kodiak, twice in Anchorage, Juneau, and twice in Fairbanks where the attendees were case managers and social service providers who, not only work with the homeless, but have case loads of clients who want to work and/or will be involved in the DVR program. At each location the CAP staff distributed CAP brochures to each attendee.

Finally, a presentation was provided to Access Alaska, an Independent Living Center, and the Alaska Center for Resource Families, both located in Anchorage. The CAP staff also made presentations to the State Vocational Rehabilitation Committee and staff at the Alaska Center for the Blind and Visually Impaired. There were approximately 293 individuals total who attended these presentations.

F. Involvement with advisory boards: One CAP advocate is 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 advocate serves as the Chair of the Evaluation Sub-Committee. The P&A Legal Director, who is partially funded by the CAP, serves as an ex-officio board member with the Alaska Brain Injury network (ABIN) and another CAP advocate serves as the chair to ABIN’s Advocacy Committee. Another CAP advocate serves as an ex-officio board member on the State Independent Living Council and as a voting board member of The Web, Anchorage’s mental health drop in center.

G. Outreach to unserved/underserved populations: The CAP has sought to provide outreach to underserved and unserved individuals through the distribution of CAP brochures to the Native Health Clinics in most western Alaskan villages, the 12 Tribal Vocational Rehabilitation Agencies, the 6 State Vocational Rehabilitation Agencies, and JBER.

The CAP also works with the Mental Health Trust Authority on various issues that impact people with disabilities in the state of Alaska, such as housing, employment, disability justice, etc.

The P&A has, and plans to continue to, set aside time to make monthly intake visits to the Veterans Administration’s Comprehensive Homeless Center (aka: the “VA Domiciliary” or “the Dom”). The CAP’s contact at the Dom works closely with their residents and calls to let us know if there will be anyone who wants to meet with P&A staff at the designated time. In FY12, staff visited 3 times. Most intakes at the Dom involve providing information and referral with an offer of more assistance if the person does not find success in following the information and referral provided. Most questions involve Social Security disability benefits however the Dom also works with residents who are trying to obtain employment and are either involved with the VA Vocational Rehabilitation program or DVR.

The CAP for FY12 has distributed 12,000 CAP tri-fold brochures. 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.

One matter that the CAP tried to resolve through the informal process had gone through a Fair Hearing in September of 2011, shortly before the P&A began as CAP operator. This was a very complicated case and it will be discussed in slightly greater detail in Section J below. The Fair Hearing did not result in a final resolution of the issues. After the P&A assumed responsibility for this case, many hours were invested in trying to resolve these outstanding issues without returning to the more formal process. In general, the issues involved reimbursement for travel, some home environmental modifications, and accessibility modifications to a van. Unfortunately, during this process, the CAP client experienced medical issues that left her hospitalized for an extended period of time. Because the client could no longer participate with DVR, her case was closed in April of 2012. The P&A closed her case in July of 2012.

As discussed in Section I below, the CAP is also working with DVR to make mediation more accessible to clients who disagree with decision made in their cases. In the past, DVR has generally refused to participate in mediation because DVR doesn’t think they will be productive and they have never identified individuals with mediation experience in the state. At this time a hearing officer would act as a mediator if requested however that same hearing office may also be the one hearing the case if mediation was not successful. In quarterly meetings with the Chief of Rehabilitation Services, this issue has been discussed and the CAP hopes to see progress towards a more robust mediation option in the year ahead.

There have been no cases that have gone to the Alternative Dispute Resolution or Fair Hearing during this reporting period with this CAP. All individuals were informed of their right to request ADR or a Fair Hearing prior to engaging in the less formal process.

I. Systemic Advocacy: During the course of delivering CAP services, the P&A identified six issues that, in our judgment, represent system-wide barriers to the receipt of services from DVR. At this time, there are no identified systemic advocacy issues related to the services provided by Tribal VR or the Independent Living Centers. Each DVR issue is discussed below.

1. Expiring IPEs. An ongoing issue the CAP has brought up with the Chief Rehabilitation Services is that IPEs will say they expire at a certain time, usually within a year of signature. However, the client’s particular goal may not be completed by that time. The CAP was informed each goal finish date was only a target to be finished or by that it is a time line to be reviewed. CAP stated this term is confusing and a more appropriate term should be used since, in several cases, the IPE goal completion date had passed and though the goal had not been reached, a new ending date for the goal was not entered into the IPE. This resulted in the counselor not reviewing the goal and the new timetable not being incorporated into the IPE. Therefore, the client was not under a current IPE. The client had no knowledge that they had an IPE that was not updated until the CAP brought this to their attention.

2. Lack of DVR communication with CAP on issues or agreements made with clients. Information or correspondence that was sent to the clients via email, phone call or mail was not forwarded to the CAP. This resulted in gaps of information that has kept CAP out of the loop. This has been bought up to the previous Chief Rehabilitation Services and will be brought up with the new person in this position. In one instance, though this case was funded through an alternate grant, a client was represented by the DLC throughout the appeals process with DVR which resulted in a Fair Hearing. The final result from the Fair Hearing determined that DVR had to reimburse the client for the fall semester of a local university due to the fact they had actively promoted a certain degree program and encouraged her to attend so that the client could obtain her employment goal. DVR did eventually reimburse the client for the cost of tuition and all school related costs for the fall semester, however, DVR never informed CAP or the assistant attorney general who represented DVR at the Fair Hearing of this reimbursement. This issue was brought up with the new Chief Rehabilitation Services at the last quarterly meeting.

3. IPE’s need to be completed in a timely manner. CAP has noticed that DVR is having a hard time completing IPE’s within the 180 day time line. During a strategic planning meeting held in October 2012, the DVR State Director acknowledged that DVR needs to do a better job on completing IPEs on time. Evaluations from consumers whose cases were closed report that their services where delivered in a timely manner at a rate of 80%. The Director would like to see that percentage go up to 95%.

4. DVR to cite regulations or policy when denying a client services. The CAP has observed that denial letters sent to DVR clients do not usually contain references to the regulation or policy relied upon for the decision. Those letters need to be more informative to the client as to the reason DVR is closing their case and the citation that is appropriate with the closing.

5. Availability of Mediation. The CAP was made aware that, though mediation is available to clients prior to going to Fair Hearing, DVR was continually refusing to mediate, thereby forcing clients to go straight to Fair Hearing. Though DVR has the right to do this, the reasons that were given to clients to justify their choosing not to participate in mediation were questionable. The CAP has raised this issue with the new Chief of Rehabilitation Services and advocated for mediation as a good possible alternative to going straight to Fair Hearing due to the money and resources that could be saved, as well as a better end result for the client and DVR. As a result, DVR is looking closer at utilizing mediation as a resolution tool.

6. Annual IPE reviews. With at least two clients, the DVR counselors have not conducted the annual review of the IPEs in a timely manner and/or with their actual clients. This has resulted in either delay of services or cancelation of some services. This issue was also brought up with the pervious Chief Rehabilitation Services and will be brought to the attention of the new Chief Rehabilitation Services during the upcoming quarterly meeting.

J. Interesting Cases: The following two cases are representative of complicated situations that are not typical cases that individuals who contact the CAP confront in their attempt to receive needed services through the state Division of Vocational Rehabilitation:

One client was transferred to the Alaska P&A CAP from the previous CAP provider. The client, who has an identified employment goal of illustrator, was frustrated with DVR and his counselor after delays in finalizing his IPE. Delays were based on the fact that DVR would not agree to pay full tuition for his art school of choice that he already had enrolled in prior to applying with DVR.

Initially, DVR would only pay the tuition for the school the client was already enrolled in up to the level of tuition of the local university. However, as the client’s disability limited him to take online classes, something the local university did not offer, the local university was not a comparable alternative. The CAP worked extensively with the client and DVR in order to either justify the client’s choice of schools or identify a comparable alternative to the school that the client was attending.

In addition, the CAP worked with the client and DVR to incorporate other services into his IPE, such as funding for computer programs needed for his classes, an ergonomic desk and chair, and travel expenses. The CAP also worked with the client and DVR to identify what the required grade point average would be during the client’s time in school.

The client remained steadfast in his school of choice and did not accept any other art school as comparable. The client eventually decided to go to Fair Hearing over DVR’s decision not to pay the tuition for his school of choice. In his request for Fair Hearing, the client also raised a variety of other issues that had not been previously discussed with CAP staff. Although the CAP did not represent the client at the Fair Hearing, staff continued to provide technical assistance throughout the hearing process so the client would be empowered to advocate for himself.

This next case was not only unique but also very complex. As briefly mentioned in Section H, an Administrative Review was requested by an individual with the previous CAP 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. Her Administrative Review was denied and the client, with the assistance of the previous CAP, requested a Fair Hearing that was held in September 2011.

The Impartial Hearing Officer (IHO) 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 work out the options and costs so the individual could be involved in making an informed choice.

By the time the IHO decision was made, this case was transferred to the Alaska P&A CAP in October 2011. When comparative costs were provided to all parties, it was clear DVR’s cost estimate, which did not include travel for the children, was lower than the client’s. Advocating on behalf of the client for her children’s travel was difficult in that it had no bearing on her employment outcome. However, it would be appropriate for DVR to pay the husband’s airline cost as a care companion. A meeting was held with the client, CAP, and DVR at the end of October 2011 where all agreed that DVR would pay for her transportation, her chair (which needed to be shipped air cargo because of the size), and her husband would get a stipend of $1,200 that could be used for transportation and for what he needed in being her care companion. The hotel expense and per diem would be paid for by DVR for the client.

The agreed upon plan gave the client responsibility to obtain flight information for when she was leaving the next week (which she was adamant that she could only travel in that time frame and was not flexible on changing) and the return flight. DVR’s responsibility would be to obtain the cost to ship her chair. The client was supposed to have the travel information back to DVR by the close of business of the day of the morning meeting so DVR could work on getting the financial costs cleared and processed with their travel and revenue departments.

Unfortunately, the client did not furnish the requested information until a day later, complaining that she should not have had a time frame put on her since she was at a doctor visit. Although she was late in providing her information, she was unwilling to change her travel time to allow DVR to process the travel cost before her demanded departure in 3.5 days.

For the next month, CAP staff tried to have the client come back to the table with DVR. After repeated efforts to find a date and time that would work for the client, CAP staff received a call from the client stating that she was in the hospital and was not able to make any meetings. CAP went to visit her a few times and each time the client would not provide the CAP staff with guidance on how to advocate on her behalf. After 4 months in the hospital, DVR closed her case near the end of April 2012 since she could not participate with them.

In April, the client requested that the van be shipped up so her husband could drive her around when she is out of hospital. A CAP staff had been communicating with the company in Seattle, WA that was going to do the final modifications and fittings on the van. This company needed time to put the van seat back in place and finish work on the cables that help move the chair forward or back and wanted a confirmation letter from the client before they could begin.

In mid June, the CAP advocate spoke with this company who said the van was ready to ship but they needed a letter from the client that her request means the van is not fitted for her chair. Basically, they want her to acknowledge that the original seat was refitted into the van and it was not fitted for her wheelchair and she needs to approve this before they will ship the van. The CAP advocate relayed this information to the client and gave her the number to call the appropriate person at this company. As the client was no longer engaged with DVR and did not know when she would be released from the hospital, the CAP mailed her a closure letter in July 2012.

K. On-line information/outreach: The Disability Law Center of Alaska has a website at www.dlcak.org which includes a page dedicated to CAP information here: http://www.dlcak.org/html/about-us/client-assistance-program.php

There is also an email contact (akpa@dlcak.org) for individuals who prefer to email the CAP. This past year there were 64,609 visits to the website.

Certification

Approved

This Report is Complete and Correct.Yes
Date Signed:19-Dec-12
Name of Designated Agency Official:Karen Tessandore
Title of Designated Agency Official:Development Coordinator