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

Alabama (ALABAMA DIVISION OF REHAB. SERVICES AND CHILDREN’S REHAB SERVS) - H161A130057 - FY2013

General Information

Designated Agency Identification

NameAlabama Department of Rehabilitation Services
Address602 S. Lawrence Street
Address Line 2
CityMontgomery AL
StateAlabama
Zip Code36104
E-mail AddressCary.Boswell@rehab.alabama.gov
Website Addresshttp://www.rehab.state.al.us
Phone334-293-7200
TTY 334-293-7500
Toll-free Phone1-800-441-7607
Toll-free TTY1-800-441-7607
Fax334-293-7383

Operating Agency (if different from Designated Agency)

NameAlabama Department of Rehabilitation Services
Address602 S. Lawrence Street
Address Line 2
CityMontgomery AL
Zip Code36104
E-mail AddressCary.Boswell@rehab.alabama.gov
Website Addresshttp://www.rehab.state.al.us
Phone334-293-7200
TTY334-293-7500
Toll-free Phone1-800-441-7607
Toll-free TTY1-800-441-7607
Fax334-293-7383

Additional Information

Name of CAP Director/CoordinatorRachel L. Hughes
Person to contact regarding reportRachel L. Hughes
Contact Person Phone334-263-2749

Part I. Agency Workload Data

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the Rehabilitation Act7
2. Information regarding Title I of the ADA2
3. Other information provided7
4. Total I&R services provided (Lines A1+A2+A3)16
5. Individuals attending trainings by CAP staff (approximate)380

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)7
2. Additional individuals who were served during the year12
3. Total individuals served (Lines B1+B2)19
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. 7

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 favor5
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 individual4
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)0
5. Individual chose alternative representation0
6. Individual decided not to pursue resolution3
7. Appeals were unsuccessful0
8. CAP services not needed due to individual's death, relocation, etc.0
9. Individual refused to cooperate with CAP1
10. CAP unable to take case due to lack of resources0
11. Other (please explain)

N/A

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/implemented0
6. Communication re-established between individual and other party2
7. Individual assigned to new counselor/office4
8. Alternative resources identified for individual6
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 under2
2. 22 - 405
3. 41 - 6411
4. 65 and over1
5. Total (Sum of Lines A1 through A4. Total must equal Line I.B3.)19

B. Gender

Multiple responses not permitted.

1. Female6
2. Male13
3. Total (Sum of Lines B1 and B2. Total must equal Line I.B3.)19

C. Race/ethnicity

1. Hispanic/Latino of any race0
For individuals who are non-Hispanic/Latino only
2. American Indian or Alaskan Native0
3. Asian0
4. Black or African American10
5. Native Hawaiian or Other Pacific Islander0
6. White9
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 impairments1
3. Deafness2
4. Hard of hearing0
5. Deaf-blind0
6. Orthopedic impairments5
7. Absense of extremities0
8. Mental illness6
9. Substance abuse (alcohol or drugs)0
10. Mental retardation0
11. Specific learning disabilities (SLD)2
12. Neurological disorders1
13. Respiratory disorders0
14. Heart and other circulatory conditions0
15. Digestive disorders0
16. Genitourinary conditions0
17. Speech Impairments0
18. AIDS/HIV positive0
19. Traumatic brain injury (TBI)0
20. All other disabilities0
21. Disabilities not known0
22. Total (Sum of Lines D1 through D21. Total must equal Line I. B3.)19

E. Types of individuals served

Multiple responses permitted.

1. Applicants of VR Program1
2. Clients of VR Program16
3. Applicants or clients of IL Program0
4. Applicants or clients of other programs and projects funded under the Act2

F. Source of individual's concern

Multiple responses permitted.

1. VR agency only16
2. Other Rehabilitation Act sources only1
3. Both VR agency and other Rehabilitation Act sources1
4. Employer1

G. Problem areas

Multiple responses permitted.

1. Individual requests information1
2. Communication problems between individual and counselor7
3. Conflict about services to be provided12
4. Related to application/eligibility process1
5. Related to IPE development/implementation1
6. Other Rehabilitation Act-related problems0
7. Non-Rehabilitation Act related0
8. Related to Title I of the ADA1

H. Types of CAP services provided

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

1. Information/referral7
2. Advisory/interpretational3
3. Negotiation7
4. Administrative/informal review0
5. Alternative dispute resolution0
6. Formal appeal/fair hearing0
7. Legal remedy0
8. Transportation0

Part III. Narrative

Narrative

Type of agency used to administer CAP: The State of Alabama Client Assistance Program is not sub-contracted and is housed independently from the Alabama Department of Rehabilitation Services. The program has complete autonomy with the parameters established by the 1973 Rehabilitation Act, as amended.

Sources of funds expended: Federal dollars fund the State of Alabama Client Assistance Program. The program did not received funds from any other source.

Source of Funding Total expenditures on individuals Federal funds 151 056 State funds N/A All other funds N/A Total from all sources 151 056

Budget for current and following fiscal year

Category Current Fiscal Year Next Fiscal Year Wages & Salaries 95728 95428 Fringe Benefits 35230 35230 Materials/Supplies 5600 10000 Postage N/A N/A Telephone 2500 2500 Rent 14500 14500 Travel 5770 5770 Copying N/A N/A Bonding/Insurance N/A N/A Equipment Rental/Purchase 730 1000 Legal Services N/A N/A Indirect Cost 14177 14177 Miscellaneous 3000 3000 Total Budget 177235 177235

Number of person-years

Type of Position Full-time Equivalent % of year filled Person-years Professional Full-time 1 100 1 Part-time -0- -0- -0- Vacant -0- -0- -0- Clerical Full-time 1 100 100 Part-time -0- -0- -0- Vacant -0- -0- -0-

Summary of presentations made We continue to do advocacy and goal setting training for customers and rehabilitation professionals. SACAP brochures continue to be used by ADRS counselors and centers. Many community rehabilitation centers continue sending employees out to meet customers instead of having customers come to them for training and job development. Therefore, the number of customers are fewer in number. Other presentations include customer advisory groups and various conferences. Many customers have taken advantage of our on-line web page and have made complaints using this system.

Involvement with advisory boards The SACAP director/advocate has a seat on the State Rehabilitation Council that meets quarterly. She sits on the Program Evaluation/Customer Services Subcommittee. Policy matters, production, State and Federal regulations, and other pertinent matters are discussed at these meetings. The SACAP director/advocate also attends as many local Customer Rehabilitation Advisory Committees around the state as possible. She attempts to attend the meetings of the State Independent Living Council (SILC) and the Council of Organizations Serving Deaf Alabamians (COSDA). SACAP director/advocate also sits on the board and is actively involved in the Full Life Ahead Foundation. This foundation seeks to work with individuals with severe disabilities and their families. Finally, director/advocate serves on the Board as President Elect for the Alabama Rehab Association (ARA).

Outreach to unserved/underserved populations SACAP director/advocate provides services to customers of Full Life Ahead who may not be involved in a vocational rehabilitation program or serves to assist those individuals who may have trouble with vocational rehabilitation. These efforts have allowed customers to utilize various programs that ADRS has to offer as well as networking with other professionals.

A survey continues to be sent to individuals after their SACAP case is closed. Of the 19 customers that were served, only a few returned. In those cases, most individuals were happy with the services that they received from the Client Assistance Program. There were a couple of customers that stated that they did not receive what they wanted from CAP or VR.

Alternative dispute resolution All of our successes for our customers have come about by alternative dispute resolution techniques.

In using alternative dispute techniques, in which SACAP represents the customer, it has made a tremendous impact. The customer, the counselor, and the counselor’s supervisor will attend a meeting so that everyone knows what is being discussed with each individual having an opportunity to participate. SACAP has found that when all parties get together and discuss the concern, the customer and counselor leave with a better understanding of each other and respect is often salvaged. If a customer makes a request that complies with the Rehabilitation Act or the Alabama Department of Rehabilitation, customers have been granted their requests. In situations where it could not be granted, the policy was explained to the customer. Many attempts were made to find other ways of providing services by ADRS that were within regulations or finding other resources within the community.

Systemic Advocacy Many consumers this year made a request from VR that under federal and state law could not grant. However, if a consumer would allow the Client Assistance Program Director/Advocate to brainstorm with them along with VR, we can usually find a direction that will work for the consumer and VR.

Interesting Case Although, many VR counselors often have some type of evaluation in a consumers file, due to multiple disabilities, the evaluations are not extensive enough to give the consumer or counselor the kind of information needed to produce a successful placement. Hence, the need to call CAP because the consumer isn’t making any real progress. Although, the majority VR counselors seemed to be working the case.

It’s easy to give a description of a case that CAP worked that came out successful. The case I’m going to discuss does not have the kind of closure we want to see yet the case contains the same type of activities that have been successful in so many other cases.

The case was opened in November 2012. At the time, the consumer had a VR counselor and was participating at a vocational rehab center. The consumer called and stated that although he wasn’t unhappy with the people that were working with him he just didn’t feel that progress was being made in helping him to find employment.

After reading the case material, talking with the consumer, VR counselor, and employment specialist from the rehab center, it seemed that they were all in agreement that a lot of effort was being spent in looking for employment. Unfortunately, the efforts had been unsuccessful.

A meeting was scheduled with the consumer, VR counselor, a (new employee) job developer for VR, employment specialist from the rehab center, her director, and CAP director/advocate. We discussed what had been done and looked at some new approaches that could be used. Even though, a vocational evaluation had been done at the beginning of the year, it did not seem to be effective for the consumer. The consumer would sometimes decide that he really did not want to do a job that matched his employment choice based on the evaluation or that he did not like something about the job and would not interview.

Another issue that kept surfacing from the consumer’s point of view is another rehab program that he had participant. The consumer states he did not understand why he could no longer participate in the program. Unfortunately, there wasn’t any information in the file regarding to what had happened. There was a reference to him participating in the program but not what had happened.

Following the meeting, the recommendations for making a list of jobs, attending and successfully completing a "Readiness to Work Class" at a nearby college, and having an additional employment specialist work on finding jobs seemed to be making a difference.

The CAP case was just about to be closed, when the whole process went down the tubes. Due to the nature of the collapse, SACAP advocate requested a change in counselor which was granted. Both counselor and supervisor agreed that the case was at an impasse.

There had been a recommendation from the present VR counselor for a psychological. Advocate suggested proceeding with the psychological to get some direction. Within the same month, consumer met with the psychologist, his new VR counselor, and was provided feedback from the psychologist. The consumer, his mother, new VR counselor, unit supervisor, psychologist, and CAP advocate was all present at the meeting. There were recommendations that were made by the psychologist. After the meeting, the consumer, his mother, and VR counselor developed his Plan for Employment.

Several weeks later, consumer decided that he did not want to follow the plan or the recommendations from the evaluation. The counselor decided additional information was necessary and requested case files from previous counselors. In reviewing the case material, it was noted as to what had happened at the previous rehab center and what had transpired from his other rehab programs. It did not appear that the consumer would follow any of the recommendations from previous counselors or the rehab center. There was a sequence of events that seemed to be occurring with each counselor. The pattern for whatever reason had not been detected.

Another meeting was scheduled which included the consumer, his friend, VR counselor, unit supervisor, and CAP advocate. A recommendation was made for the consumer to see a neurologist/psychiatrist/educational psychologist or some other qualified individual. We felt this could lead to further testing but agreed that this was a good place to start. The VR counselor wanted to look at the vendor list not knowing who to use or even recommend to the consumer. After the meeting, the unit supervisor suggested calling Lakeshore rehab center and ask who they would recommend as a consultant.

A consultant and neuropsychologist to Lakeshore agreed to review the psychological and case records in order to give us some ideas on what he believed needed to be the next step. The consumer requested to speak to the same doctor we were consulting. The doctor agreed to the request and we begin looking at some possible dates in order to provide services as quickly as possible.

The consumer’s friend stated he wanted to confirm accompanying and observing the consumer while the neuropsychological evaluation took place. The consumer was told that his friend could accompany the consumer to the evaluation but would not be allowed in the room while the evaluation was taking place.

The consumer and his friend would not agree with this arrangement. Unfortunately, there wasn’t any room left to make any compromises. A letter was then written to the consumer to give him the date of the evaluation if he still choose to participate. There was a detailed description of what to do if he were dissatisfied with this direction and his right to request an administrative review, mediation or a formal impartial hearing.

The consumer responded (September 2013) that he would choose an administrative review and asked that it take place in 2014. A response from the administration ask that the consumer contact them again in January 2014 in order for them to schedule a mutually convenient date.

There were so many opportunities to allow the consumer client choice. All requests from the consumer were supported in order to accommodate his needs but one. It is important to have good evaluations but it is also important to look at previous cases in order not to make the same mistakes twice. The VR counselors and unit supervisor from this district worked well with CAP to change the outcome of this consumers rehab experience and employment outcome.

Certification

Approved

This Report is Complete and Correct.Yes
Date Signed:27-Dec-13
Name of Designated Agency Official:Rachel L. Hughes
Title of Designated Agency Official:SACAP Director/Advocate