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

Maine (C.A.R.E.S., Inc.) - H161A120020 - FY2012

General Information

Designated Agency Identification

NameBureau of Rehabilitation Services
Address150 State House Station
Address Line 2
CityAugusta
StateMaine
Zip Code04333-0150
E-mail AddressPaul.E.Cote@state.me.us
Website Addresshttp://www.maine.gov
Phone207-624-5977
TTY 207-624-5977
Toll-free Phone1-888-755-0023
Toll-free TTY1-888-755-0023
Fax207-624-5980

Operating Agency (if different from Designated Agency)

NameBureau of Rehabilitation Services
Address150 State House Station
Address Line 2
CityAugusta
Zip Code04333
E-mail AddressPaul.E.Cote@state.me.us
Website Addresshttp://www.maine.gov
Phone207-624-5977
TTY207-624-5977
Toll-free Phone1-888-755-0023
Toll-free TTY1-888-755-0023
Fax207-624-5980

Additional Information

Name of CAP Director/CoordinatorKathy Despres
Person to contact regarding reportKathy Despres
Contact Person Phone207-377-7055

Part I. Agency Workload Data

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the Rehabilitation Act97
2. Information regarding Title I of the ADA1
3. Other information provided65
4. Total I&R services provided (Lines A1+A2+A3)163
5. Individuals attending trainings by CAP staff (approximate)120

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)27
2. Additional individuals who were served during the year60
3. Total individuals served (Lines B1+B2)87
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. 24

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 favor25
2. Some issues resolved in individual's favor (when there are multiple issues)9
3. CAP determines VR agency position/decision was appropriate for the individual17
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)1
5. Individual chose alternative representation3
6. Individual decided not to pursue resolution5
7. Appeals were unsuccessful0
8. CAP services not needed due to individual's death, relocation, etc.1
9. Individual refused to cooperate with CAP2
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 individual34
2. Application for services completed.1
3. Eligibility determination expedited1
4. Individual participated in evaluation1
5. IPE developed/implemented8
6. Communication re-established between individual and other party13
7. Individual assigned to new counselor/office3
8. Alternative resources identified for individual1
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 under8
2. 22 - 4031
3. 41 - 6445
4. 65 and over3
5. Total (Sum of Lines A1 through A4. Total must equal Line I.B3.)87

B. Gender

Multiple responses not permitted.

1. Female35
2. Male52
3. Total (Sum of Lines B1 and B2. Total must equal Line I.B3.)87

C. Race/ethnicity

1. Hispanic/Latino of any race2
For individuals who are non-Hispanic/Latino only
2. American Indian or Alaskan Native2
3. Asian0
4. Black or African American6
5. Native Hawaiian or Other Pacific Islander0
6. White77
7. Two or more races0
8. Race/ethnicity unknown0

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Blindness (both eyes)1
2. Other visual impairments2
3. Deafness1
4. Hard of hearing3
5. Deaf-blind2
6. Orthopedic impairments5
7. Absense of extremities0
8. Mental illness47
9. Substance abuse (alcohol or drugs)0
10. Mental retardation4
11. Specific learning disabilities (SLD)8
12. Neurological disorders1
13. Respiratory disorders1
14. Heart and other circulatory conditions1
15. Digestive disorders0
16. Genitourinary conditions0
17. Speech Impairments0
18. AIDS/HIV positive0
19. Traumatic brain injury (TBI)4
20. All other disabilities7
21. Disabilities not known0
22. Total (Sum of Lines D1 through D21. Total must equal Line I. B3.)87

E. Types of individuals served

Multiple responses permitted.

1. Applicants of VR Program7
2. Clients of VR Program80
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 only87
2. Other Rehabilitation Act sources only0
3. Both VR agency and other Rehabilitation Act sources0
4. Employer0

G. Problem areas

Multiple responses permitted.

1. Individual requests information87
2. Communication problems between individual and counselor76
3. Conflict about services to be provided65
4. Related to application/eligibility process7
5. Related to IPE development/implementation34
6. Other Rehabilitation Act-related problems3
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/referral13
2. Advisory/interpretational34
3. Negotiation15
4. Administrative/informal review0
5. Alternative dispute resolution1
6. Formal appeal/fair hearing0
7. Legal remedy0
8. Transportation0

Part III. Narrative

Narrative

NARRATIVE REPORT FISCAL YEAR 2012

I. Introduction

The Bureau of Rehabilitation Services is the designated agency for the Client Assistance Program (CAP) in Maine. Since 1984 the State Agency has subcontracted with outside agencies to provide CAP services throughout the state of Maine. C.A.R.E.S., Inc., in existence since November 1, 1988, is a closely held, for-profit corporation making the Maine CAP an external-other organization. Since September 1992, Consulting, Advocacy, Research and Evaluation Services, Inc. (C.A.R.E.S., Inc.) has been effectively administering the CAP in Maine. CAP offers the full range of services required by Section 112 of the Rehabilitation Act. The CAP is staffed by three professionals for a total of three (3) person-years. Two of the professionals are full-time (2.0 FTE), the third is part-time (.20 FTE). Additionally, C.A.R.E.S., Inc. has a retainer agreement with a qualified attorney for the purpose of and legal consultation to CAP personnel and, if required, providing legal representation to CAP consumers

The FY 2012 budget is enclosed as Attachment II. In FY 2012 the federal funds expended for the CAP were supplemented by SSA-VR funds.

During FY 2012 the CAP achieved all program goals and objectives in the following areas: Informing the general public and consumer organizations about CAP; informing consumers of their rights to services under the Act and advocating for these rights; developing a positive working relationship with appropriate agencies; advising the state agency about systemic issues and obtaining training for CAP personnel.

Our Consumer Advisory Board (CAB) met 4 times during the fiscal year. The CAB assists program staff to identify systemic issues in delivering vocational rehabilitation and independent living services to people with disabilities as well as assessing consumer satisfaction concerning services received from the Client Assistance Program. During the year the CAB received information about DVR and DBVI (staffing issues, systemic concerns) and also reviewed the Consumer Satisfaction Survey Form that we mail out to our clients after a case is closed by CAP.

CAP has an open and productive relationship with both directors and with the management staff of the 2 agencies. While we have regularly scheduled meeting (as stipulated in our contract) to discuss systemic issues, we are able to access key staff on an “as needed” basis. CAP’s viewpoint, while not always agreed with, is clearly welcomed by state agency personnel. CAP’s scheduled access was provided via quarterly meetings with the agency directors and with other key staff from Central Office, and through our participation in both State Rehabilitation Councils (SRCs). CAP is a mandated member of and an active participant in the SRC for both the Division for Vocational Rehabilitation (DVR) and the Division of the Blind and Visually Impaired (DBVI). (See Section V).

II. Information and Referral

During the reporting period, (163) individuals received information and referral (I&R) services from C.A.R.E.S., Inc. Of this total, (97) individuals received information and referral services regarding the Rehabilitation Act, 1 regarding Title I of the ADA and 65 individuals were provided other information. Examples of “other” information and referral services include a variety of requests such as social security, special education, DHHS services, unemployment, disability/advocacy agencies and community rehabilitation providers, MaineCare, family violence resources, fuel assistance, assistive technology, housing, resources for people who are homeless, health insurance, resources for veterans, etc.. CAP staff uses VR/IL I&R related requests to emphasize self-advocacy and empowerment of people with disabilities. The CAP staff also used information obtained from I&R requests to identify trends, patterns and issues of a systemic nature. This information was provided to State Agency staff during our regularly scheduled quarterly meetings and as appropriate. Finally, requests for information and referral were used to identify potential training needs within both the CAP and the state agencies.

III. Client Data

Along with the 163 individuals who requested and received information and referral services, 87 individuals were served as “cases” as defined by the RSA-227 reporting instructions. Of the 87 individuals served as open/active cases, 27 were pending as of October 1, 2011. Another 60 individuals had cases opened with CAP during the fiscal year. Seven (7) individuals were applicants of Title I, Vocational Rehabilitation (VR) Program and 80 individuals were Title I consumers. CAP did not represent anyone who were applicants of or recipients of the Independent Living Program administrated by Alpha One. Of the open 87 cases, individuals with mental illness comprised the largest group of individuals served (47 cases). They were followed by individuals with learning disabilities (8), other disabilities (7 cases), orthopedic impairments (5), mental retardation (4), traumatic brain injury (4), hard of hearing (3), visual impairment (2), deaf blind (2), blindness (1), neurological disorder (1), respiratory disorder (1), deaf (1), and finally, heart/circulatory (1).

During the past fiscal year, 63 cases were closed. Of this figure, 25 were closed with all issues resolved in the individual’s favor, while another 9 cases were closed with some issues resolved in the individual’s favor when there were multiple case problems. In 17 cases CAP determined that the VR agency had taken appropriate action. CAP did not represent any individuals at either a due process hearing or mediation during FY 2012. We estimate that CAP resolved 27 potential due process hearings via alternative dispute resolution during the past fiscal year. Issues involved include case closure, self- employment, service delivery, eligibility and evaluation.

CAP staff responded to the following problem areas for the 87 individuals we represented: Information requested (87), communication problems between individual and counselor (76), conflict regarding services to be provided (65), problems related to IPE development/implementation (34) and problems related to the application/eligibility process (7). Obviously, multiple responses are permitted for open cases.

During the past fiscal year Maine’s CAP represented individuals in all five VR regions; 22 cases were in Region 1; 28 in Region 2; 20 in Region 3; 16 in Region 4 and 1 case in Region 5. Of the 87 individuals we represented during the year, 35 were females and 52 were males. There were 8 individuals served under age of 21; 31 clients from ages 22-40; 45 from ages 41-64 and there were 3 clients represented who were over the age of 65.

(Please see Attachment I for examples of cases handled during FY 2012)

IV. Training, Outreach and Linkage Activities

A. Training Received. During FY 2012 CAP staff received the following training to enhance our skills:

1. CAP staff attended the Statewide Bureau of Rehabilitation Services training in June, 2012.

2. A CAP staff member attended the Council of State Administrators of VR Annual Conference in Bethesda, MD. A portion of that conference is dedicated to training for members of the State Rehabilitation Councils throughout the country. No CAP funds were used to attend this conference.

3. CAP staff received training at the 2 SRC Annual Conferences.

4. CAP staff received 30 hours of license related consultation.

5. CAP staff attended the AT Consortia meeting and Self-Employment group.

6. CAP staff attended the Consumer Satisfaction Survey meeting with DVR.

B. Training Provided. During FY 2012, CAP staff provided the following training to consumers, family members and professionals:

1. CAP staff provided an overview of the role of CAP and the appeals process as part of new counselor orientation. We provided this training twice during FY 2012.

2. CAP staff provided an overview of CAP services and case trends in Regions 3, 4 and 5.

C. Linkages/Outreach with consumers, family members, advocacy organizations and community agencies occurred on a regular and as-needed basis during the past year. Examples of those contacts are as follows:

1. Alpha One 2. Maine Consumer Information and Technology Exchange (Maine CITE) 3. Pine Tree Legal Services 4. State Rehabilitation Councils (both DVR and DBVI) 5. Maine Parent Federation 6. Mental Health Providers 7. Houlton Band of Maliseet Indians 8. Disability Rights Center 9. Goodwill of Northern New England 10. Maine Vocational Rehabilitation, Assoc. 11. Employment Support Services 12. Assumption College/TACE 13. Alliance for the Mentally Ill 14. Developmental Disabilities Council 15. Alternative Services, Inc. 16. Creative Works Systems 17. National Protection & Advocacy Services 18. Rehabilitation Services Administration 19. Motivational Services, Inc. 20. Statewide Independent Living Council 21. Catholic Charities of Maine 22. Employment Specialists of Maine 23. Maine Children’s Alliance 24. Maine Center on Deafness

V. Systemic and Policy Issues

The Client Assistance Program continues to place considerable emphasis and program resources on systemic advocacy. During the past year our involvement in the State Rehabilitation Councils for both agencies presented us with many opportunities to provide input on issues that have systemic implications for individuals with disabilities. Over the past several years, CAP staff has played a significant role in the 2 councils. Fiscal year 2012 was no different. For example, a CAP staff person served as the Chair for the DBVI SRC. Within the framework of the SRC, we reviewed and commented on the proposed State Plans for both agencies. Additionally, CAP staffs were actively involved in assisting with LD 765 legislation by meeting with Commissioners of Department of Labor and Department of Education.

CAP staff continues to be involved with committees that have systemic implications. Examples of these committees include:

• DVR/SRC Policy Committee. This committee provides input into the State Plan, Comprehensive Needs Assessment, agency procedural directives and important topical areas. During the past year, CAP staff provided input on the revised procedural directive for working with Department of Corrections/Probation clients.

• Participation in internal BRS Committee, Self-Employment Services. CAP’s role on this committee has been to present individual case considerations as the agency develops procedural directives and training for staff members.

Staff from Maine’s CAP continued to be a member of the Region I Technical Assistance and Continuing Education (TACE). We feel our participation on the TACE Advisory Committee presents an excellent opportunity to provide input on VR staff training needs. As a member of this committee, the Maine CAP staff person also plans and organizes staff training for all New England CAP personnel, a target group within the TACE.

The CAP Program Director is a member of the Wabanki Vocational Rehabilitation Program’s Advisory Committee. This program is the first Maine recipient of Section 121 funds under the Rehabilitation Act.

VI. Other Activities

During the past year, CAP staff met with the Directors of both agencies and other staff from Central Office on a quarterly basis per the contract between C.A.R.E.S. Inc and the Bureau of Rehabilitation Services. The purpose of the meetings is to review cases being handled ay the CAP, and to identify and discuss any trends and systemic issues concerning the delivery of employment services for people with disabilities. We feel this provides CAP with an excellent forum to share information about clients are feeling about their experience with the state agency.

ATTACHMENT I

THE FOLLOWING CASES ARE REPRESENTATIVE OF OUR ADVOCACY EFFORTS IN FY 2012 ON BEHALF OF PEOPLE WITH DISABILITIES

(Client names have been changed to protect confidentially)

Problem: Bart contacted CAP after meeting with his VRC and the issue of case closure came up. Bart had not attained his vocational goal but was actively pursuing employment in his chosen field. The VRC wanted to close his case successful as the client had obtained part time employment in a field unrelated to his vocational goal and did not match his skills and abilities.

Intervention Summary: CAP reviewed the case file and met with the VRC and CWS. A change of counselor was requested and granted.

Outcome: Client’s case did not close and he continues to receive the necessary services to assist him in achieving his vocational goal.

Problem: Lisa called CAP after learning that VR was no longer going to provide funds for services spelled out in her business plan and IPE.

Intervention Summary: CAP reviewed the case file and met with both the VRC and CWS. VR was unwilling to provide funding for services spelled out in the IPE because VR had paid out in excess of the $7500 per self-employment policy. Because the approved business plan was in place as well as a current IPE indicating the necessary services, we advocated for VR to pay for the services as agreed. Additionally, the federal rules do not limit the amount of funds VR contributes toward a self-employment plan.

Outcome: VR did pay for the services and the client continues to operate her small business.

Problem: Marge called CAP because her request for additional funding towards her small business was denied.

Intervention Summary: A review of the case record indicated that the clients small business had not been earning money for over a year, yet the case was still open. VR had fully funded the plan and was unwilling to provide further funds until the client could substantiate the necessity of additional funding. VR was now looking to close her case unsuccessful.

Outcome: CAP explained to the client VR’s policy on self-employment and their position regarding her request for additional funding. Client agreed that additional funds were not going to improve her business in such a way that she would make a profit. Client agreed to the unsuccessful close of her case. CAP agreed with the position of VR.

Problem: Homer was a second time client with the CAP. The client was in a secondary education program and was seeking assistance with DVR in order to get accommodations at his school. DVR sent the client for a neuropsychological evaluation which the client did not agree with the diagnosis.

Intervention Strategy: Writer spoke with the client and DVR staff. Writer reviewed the clients DVR file, along with the neuropsychological evaluation. Writer gathered information from other professionals that worked with the client and attend a meeting with Homer’s VR Team and the neuropsychological evaluator.

Outcome: After presenting the client’s concerns, along with the information from other professionals in Homer’s life the evaluation was determined to be null and void. Homer’s case was brought up with the Director of DVR as a possible area concern.

Problem: Maggie has had 15+ case occurrences with DVR and with her last case occurrence she was closed under the “clear and convincing” standard which she appealed and lost. Maggie felt she had made significant progress with her therapist and wanted to reapply for services with DVR.

Intervention Strategy: CAP spoke with Maggie’s new therapist, reviewed the ample former client file, and assisted Maggie in reapplying for services. CAP is now a member of the “team” assisting the client in reaching her maximum potential within the DVR system.

Outcome: Maggie was placed in 06 and did very well. Maggie is now in an IPE and is seeking employment.

ATTACHMENT II

C.A.R.E.S., INC. CLIENT ASSISTANCE PROGRAM BUDGET - FY 2013

Salaries and Wages: 1. Program Director $48,460.00 2. Field Advocate $35,000.00 3. Executive Director $9,595.00 $93,055.00 Fringe Benefits:

1. FICA $7,147.93 2. Unemployment Compensation $692.00 $7,839.93

Consultant Fees:

1. Legal Fees $4,000.00 2. Accounting Fees $2,500.00 3. Bookkeeping Fees $3,000.00 4. Training $2,080.00 $11,580.00

Rent: $4,815.00

Maintenance: $500.00

Telephone: $3,800.00 Materials/Supplies/Copying/Postage: $1,819.07

Staff Travel: $5,700.00 Bonding/Insurance: $3,500.00 Total Project Costs: $132,609.00

Certification

Approved

This Report is Complete and Correct.Yes
Date Signed:06-Dec-12
Name of Designated Agency Official:Kathy Despres
Title of Designated Agency Official:Program Director