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

Arizona (Arizona Center for Disability Law) - H161A140002 - FY2014

General Information

Designated Agency Identification

NameArizona Center for Disability Law
Address5025 East Washington Street
Address Line 2Suite 202
CityPhoenix
StateArizona
Zip Code85034
E-mail Addresscenter@azdisabilitylaw.org
Website Addresshttp://www.azdisabilitylaw.org
Phone602-274-6287
TTY 602-274-6287
Toll-free Phone800-927-2260
Toll-free TTY800-927-2260
Fax602-274-6779

Operating Agency (if different from Designated Agency)

NameArizona Center for Disability Law
Address5025 East Washington Street
Address Line 2Suite 202
CityPhoenix
Zip Code85034
E-mail Addresscenter@azdisabilitylaw.org
Website Addresshttp://www.azdisabilitylaw.org
Phone602-274-6287
TTY602-274-6287
Toll-free Phone800-927-2260
Toll-free TTY800-927-2260
Fax602-274-6779

Additional Information

Name of CAP Director/CoordinatorJohn Gutierrez
Person to contact regarding reportJohn Gutierrez
Contact Person Phone6022746287

Part I. Agency Workload Data

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the Rehabilitation Act107
2. Information regarding Title I of the ADA18
3. Other information provided10
4. Total I&R services provided (Lines A1+A2+A3)135
5. Individuals attending trainings by CAP staff (approximate)744

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)28
2. Additional individuals who were served during the year97
3. Total individuals served (Lines B1+B2)125
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.)7

C. Individual still being served as of September 30

Carryover to next year. This total may not exceed Line I.B3. 51

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 favor38
2. Some issues resolved in individual's favor (when there are multiple issues)20
3. CAP determines VR agency position/decision was appropriate for the individual0
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)3
5. Individual chose alternative representation0
6. Individual decided not to pursue resolution7
7. Appeals were unsuccessful2
8. CAP services not needed due to individual's death, relocation, etc.0
9. Individual refused to cooperate with CAP4
10. CAP unable to take case due to lack of resources8
11. Other (please explain)

We did not have any cases that were closed because of Other reasons.

E. Results achieved for individuals

1. Controlling law/policy explained to individual37
2. Application for services completed.1
3. Eligibility determination expedited1
4. Individual participated in evaluation0
5. IPE developed/implemented8
6. Communication re-established between individual and other party15
7. Individual assigned to new counselor/office4
8. Alternative resources identified for individual4
9. ADA/504/EEO/OCR/ complaint made2
10. Other10
11. Other (please explain)

Advocacy resources identified (1), Basic rights info provided (2), Received info on VR services (1), Issue closed in CAP and re-opened as AT (1), VR IPE case placed in interrupted status per client’s request (1), Client will deal with VR issue (1), Lack of resources (2), Reimbursement of co-payment obtained for client by VR (1)

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 - 4035
3. 41 - 6468
4. 65 and over4
5. Total (Sum of Lines A1 through A4. Total must equal Line I.B3.)125

B. Gender

Multiple responses not permitted.

1. Female70
2. Male55
3. Total (Sum of Lines B1 and B2. Total must equal Line I.B3.)125

C. Race/ethnicity

1. Hispanic/Latino of any race16
For individuals who are non-Hispanic/Latino only
2. American Indian or Alaskan Native4
3. Asian1
4. Black or African American23
5. Native Hawaiian or Other Pacific Islander0
6. White77
7. Two or more races4
8. Race/ethnicity unknown0

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Blindness (both eyes)4
2. Other visual impairments10
3. Deafness9
4. Hard of hearing4
5. Deaf-blind0
6. Orthopedic impairments18
7. Absense of extremities0
8. Mental illness46
9. Substance abuse (alcohol or drugs)0
10. Mental retardation2
11. Specific learning disabilities (SLD)15
12. Neurological disorders3
13. Respiratory disorders1
14. Heart and other circulatory conditions0
15. Digestive disorders0
16. Genitourinary conditions0
17. Speech Impairments1
18. AIDS/HIV positive0
19. Traumatic brain injury (TBI)2
20. All other disabilities10
21. Disabilities not known0
22. Total (Sum of Lines D1 through D21. Total must equal Line I. B3.)125

E. Types of individuals served

Multiple responses permitted.

1. Applicants of VR Program18
2. Clients of VR Program109
3. Applicants or clients of IL Program0
4. Applicants or clients of other programs and projects funded under the Act1

F. Source of individual's concern

Multiple responses permitted.

1. VR agency only116
2. Other Rehabilitation Act sources only4
3. Both VR agency and other Rehabilitation Act sources7
4. Employer0

G. Problem areas

Multiple responses permitted.

1. Individual requests information1
2. Communication problems between individual and counselor8
3. Conflict about services to be provided16
4. Related to application/eligibility process10
5. Related to IPE development/implementation3
6. Other Rehabilitation Act-related problems92
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/referral20
2. Advisory/interpretational31
3. Negotiation27
4. Administrative/informal review0
5. Alternative dispute resolution1
6. Formal appeal/fair hearing3
7. Legal remedy0
8. Transportation0

Part III. Narrative

Narrative

a. Type of Agency used to administer CAP: 1) External — Protection and Advocacy

b. Source of funds expended:

Federal Funds: $218,437 State Funds: $0 All Other Funds: $0 Total from All Sources $218,437 c. Budget for current and following fiscal years:

Category Current Fiscal Year Next Fiscal Year Wages/Salaries $119,165 $118,214 Fringe Benefits $40,101 $42,318 Rent/Parking $14,378 $13,752 Travel $3,653 $4,582 Board/Staff Meetings $568 $632 Equipment Rental/Purchase $2,880 $1,956 Materials/Office Supplies $3,268 $3,228 Telephone $2,412 $1,286 Professional Dues/Seminars $1,316 $1,210 Accounting Fees $2,127 $2,446 Bonding Insurance $2,544 $2,428 NDRN Database $484 $533 Payroll Processing Fees $480 $605 Equipment Repair $624 $726 Postage $785 $767 Trainings — Facilities/Supplies $463 $657 Reference Materials $202 $156 Consultants/Interpreters $3,880 $3,193 Copying/Printing $7 $20 Staff Accommodations $19,100 $15,375 Total Budgets $218,437 $214,084 ?

d. Number of person-years:

Type of Position Full-time equivalent % of yr. position filled Person Years Professional Full Time 1.27 100% 1.27 Part-Time 0.13 100% 0.13 Vacant 0 0 0

Clerical Full Time .41 100% 0.41 Part-Time 0.07 100% 0.07 Vacant 0 0 0

e. Summary of presentations made.

ACDL (Center) staff conducted or participated in the following 19 outreach and training activities during Fiscal Year 2014:

1) 8-Oct-13, Presentation/Training, Eastside VR Office, Tucson, AZ. Seven people attended. 2) 3-Dec-13, Presentation/Training, RSA Supervisors Meeting, Phoenix, AZ. 75 people attended. 3) 9-Jan-14, Presentation/Training, RSA District II Supervisors Meeting, Tucson, AZ. 11 people attended. 4) 9-Mar-14, Presentation/Training, Southside VR Office, Tucson, AZ. 10 people attended. 5) 21-Mar-14, Presentation/Training, ACDL’s PAIMI Council Meeting, Phoenix, AZ. 12 people attended. 6) 24-Mar-14, Presentation/Training, ASU Sandra Day O’Connor Law School, Phoenix, AZ. 30 people attended. 7) 25-Mar-14, Presentation/Training, Arizona State University, Tempe, AZ. Five people attended. 8) 12-Apr-14, Booth/Table, Connecting Tucson Disability Resource and Transition Expo, Tucson, AZ. 100 people attended. 9) 6-May-14, Presentation/Training, Epilepsy Foundation, Tucson, AZ. Seven people attended. 10) 10-Jun-14, Presentation/Training, CPSA, Tucson, AZ. 50 people attended. 11) 11-Jun-14, Presentation/Training, Manor House, Safford, AZ. Six people attended. 12) 25-Jun-14, Presentation/Training, Arizona Youth Leadership Forum/Transition to Adulthood, Phoenix, AZ. 45 people attended. 13) 8-Jul-14, Presentation/Training, Disability Empowerment Center, Phoenix, AZ. 18 people attended. 14) 31-Jul-14, Presentation/Training, Legal Options Training, Tucson, AZ. 34 people attended. 15) 6-Aug-14, Presentation/Training, Legal Options Training, Tucson, AZ. 24 people attended. 16) 8-Aug-14, Presentation/Training, ASSIST Navajo Independent Living Center Conference, Fort McDowell Indian Nation, AZ. 15 people attended. 17) 25-Aug-14, Booth/Table, Arizona Department of Education Transition Fair, Talking Stick Resort, Salt River Pima Maricopa Indian Community, 250 people attended. 18) 28-Aug-14. Presentation/Training, Arizona Bridge to Independent Living Office, Disability Empowerment Center, Phoenix, AZ. Eight people attended. 19) 18-Sep-14, Presentation/Training, Desert View High School, Tucson, AZ. 37 people attended.

Total materials disseminated at all events and mailed to clients were 786. Total attendees at the outreach events and the trainings or presentations were 744.

f. Involvement with advisory boards:

The CAP Coordinator is an active member of the State Rehabilitation Council (SRC). The CAP Coordinator also participates as a member of the Program Review Committee (PRC). This committee is particularly important to CAP since it involves monitoring and providing input to relevant issues regarding Vocational Rehabilitation (VR).

g. Outreach to Un-served/Underserved Populations:

On February 28, 2014, ACDL co-sponsored the 3rd Annual African American Symposium on Disabilities at the Desert Willow Conference Center in Phoenix, Arizona. The symposium was attended by 300 individuals, vendors and agency representatives. Workshop topics included healthcare, mental health, vocational rehabilitation, special education, and the Affordable Care Act.

On June 11, 2014, ACDL staff presented a training on the Legal Options to Guardianship to the underserved community in Safford, a small town in Southern Arizona with a large Hispanic population. Staff discussed guardianships, conservatorships, living wills, powers of attorney, and representative payees for mental health and healthcare.

A large underserved community in Arizona includes Native Americans throughout the state. On August 8, ACDL staff attended the ASSIST Navajo Nation Independent Living Center conference held on the Fort McDowell Indian Nation in Maricopa County, Arizona. Our staff presented an overview of ACDL’s programs and services. On August 25, ACDL staff attended the 14th Annual Arizona Department of Education Transition Conference organized by the Salt River Pima Maricopa Indian Community. Our staff disseminated information about ACDL’s programs and services including the CAP program and voting rights.

Short-Team Assistance Team

The Center utilizes a centralized intake system known as Short-Term Assistance Team (STAT). STAT staff initially receives all requests for assistance, including CAP issues. Our STAT is staffed by trained advocates under the direction and supervision of the Information and Referral (I&R) Supervisor and an attorney supervisor. CAP advocates have provided training to STAT staff so they can provide callers with information and referral assistance, a brief service, or short-term technical assistance at the time of their initial call to the Center. Annually, CAP staff conducts training sessions for the STAT to acquaint them with new issues relating to the CAP program which will, in turn, assist them in conducting initial interviews. Once STAT staff has conducted these initial interviews, cases are assigned to CAP staff for further advocacy services.

Center Self-Advocacy Guides

The Center disseminates 19 Self-Advocacy Guides on topics related to vocational rehabilitation rights and Title I of the Americans with Disabilities Act. CAP callers can view or download the guides from the Center’s website. The guides are available on the Center’s website 24 hours a day, seven days a week, thus facilitating outreach to our clients not only in the Phoenix metropolitan area but also in outlying areas. The majority of our callers indicated that they have access to our website and prefer obtaining copies of our materials via the internet rather than through the mail.

The following guides relating to the CAP are available from the Center: — An Overview of the Employment Protections of the Americans with Disabilities Act — How to Enforce Employment Rights under the Americans with Disabilities Act — The ADA and the Job Applicant: Recruitment, Applications and Interviews — The ADA and the Reasonable Accommodations — Drug and Alcohol Testing under the Americans with Disabilities Act — The ADA and Medical Examinations — The ADA and Confidentiality of Medical Information — The ADA and Disability-Related Harassment — Summary of Vocational Rehabilitation Rights: Eligibility for Services — Summary of Vocational Rehabilitation Rights: Evaluations — Summary of Vocational Rehabilitation Rights: Individual Plan for Employment (IPE) — Summary of Vocational Rehabilitation Rights: Vocational Rehabilitation Services — Your Appeal Rights for Disputes about Vocational Rehabilitation Services — A Summary of Your Vocational Rehabilitation Rights: Assistive Technology and Services

The Center provides guides that have been translated into plain language to accommodate our clients who may have cognitive disabilities, have a seventh grade or lower reading level or difficulty with English. The Center has a total of 17 self-advocacy guides written in plain language. The following guides relating to the CAP are listed below:

— How to File a Charge When You’ve Been Treated Unfairly — Making Your Job Work for You — Have You Been Treated Unfairly at Work? — Getting a Job When You Have a Disability — How the ADA Protects Your Medical Information at Work

The Center also has 17 of our guides translated into Spanish. All of our guides are available on our website and in alternative formats by request. All of our intake information materials have been translated into Spanish and are available at our conferences, trainings, and on our website. We have also translated surveys, training materials, and grievance procedures into Spanish.

h. Alternative dispute resolutions:

The Arizona CAP was able to resolve all their clients’ issues at the lowest level and therefore, did not need to use any alternative dispute options.

i. Systemic Advocacy:

The Arizona CAP addressed the following issues regarding systemic advocacy:

VR’s Use of their Review of Counselor Determination Form VR uses a form called the “Review of Counselor Determination Form”. Initially, CAP staff thought this would be a constructive idea, since this form could be used by clients to file appeals. Additionally, this form included the timelines for when a client needed to file an appeal. However, VR Counselors appear to be misusing this form. As a result Counselors are no longer trying to negotiate and resolve issues on behalf of their clients. Instead when a client has a VR concern , the clients are immediately given this “Review of Counselor Determination Form”. CAP staff has noticed an alarming number of clients that are going to hearings because they fill out this form. The CAP Director recently told Rehabilitation Services Administration (RSA) administrators that VR Counselors are not trying to resolve issues with their clients and instead Counselors simply provide their clients with this form. Most clients do not realize that filling out these forms will lead to having to undergo an Administrative Fair Hearing, a situation that has shown to be a time consuming and traumatic experience for some VR clients.

CAP staff has spoken with the RSA Director of VR and explained that Counselors are taking the easy way out by simply providing clients with this form, without trying to resolve client issues by actually meeting and discussing a possible solution that may address their client’s concerns. VR’s Contracted Consultants Denying VR Clients’ Services CAP staff has noticed that many of the consultants that are working with VR clients are making the final decisions on whether VR clients are to receive specific services. Consultants appear to be acting with authority as VR Counselors in making the final decision on whether a client receives service. CAP staff has seen this in various areas where VR uses consultants to provide services to clients. Some of these consultants provide such services as visual evaluations, psychological evaluations, or evaluations where specific therapies are being requested by clients. It appears that VR Counselors, instead of making their own determination, accept the consultant’s decisions as the final word and, therefore, claim because the consultant states a client should not have a service that becomes the justification by VR Counselors as the reason for denying a service. An example of this is client B.G. B.G. had severe dental issues which were causing her front teeth to fall out on a constant basis. B.G. had a dental evaluation done with one of VR’s consultants who claimed it was her responsibility to take care of her own dental problems. VR agreed with the consultant and denied B.G. the dental services she required. When the advocate reviewed the file, it was determined that VR was sending B.G. to work in the field as a Behavioral Tech, which means she would be working with the public. Also, VR was sending B.G. to school to obtain a certification in this field. Advocate met with this client and was able to see that this client was holding her hand to her mouth to keep her teeth from falling out. Advocate met with the client and Supervisor and explained that it was crucial that this client had to have her dental needs addressed, especially since VR was providing all the other services which would help this client become employed in the public sector. After meeting with the advocate, the Supervisor agreed to overturn the denial of the dental consultant.

CAP staff has spoken to RSA Administration about this growing problem in the past. RSA Administration stated they would look into this issue and inform consultants of their role. However, CAP staff continues to see this issue.

Clients Experiencing Severe Delays in Services

Arizona VR clients continue to experience significant delays in receiving funds for services from VR. The VR process is multi-layered and takes an inordinate amount of time for checks to be written and delivered to clients. These delays are now furthered by the reduced number of VR Counselors and the number of new Counselors who must obtain Supervisor review and approval for all service purchases. One client waited four weeks to get funds to purchase clothes for an interview. By the time he got the funds, he had missed the interview. Additionally, numerous clients attending college with VR’s support are forced to purchase their own textbooks because VR does not get them the funds in a timely manner. Other clients pay for transportation and food while they wait their VR funds. One client received several parking tickets because VR did not pay his disability parking fee at college. Another client paid for her own tutor while VR took time figuring out how to get payment for this service approved. The clients who must initially pay for IPE services not only risk going without other basic daily living needs but also risk experiencing stress and anxiety about falling behind in classes and/or failing their classes in addition to already having complications in their lives due to having various disabilities. CAP assists clients with being prepared to provide VR all the information required in order to assist their VR Counselors in making the funding process go smoothly. CAP staff follows up with the Counselors on each step of their process to ensure that our clients are provided with the services they require as efficiently as possible.

VR Has Hired Too Many New Counselors with Very Little Knowledge of the VR Program

During the former RSA Administration, this agency lost approximately 150VRCounselors. During this time there was an overabundance of upheaval and lack of direction with this Administration which caused VR Counselors to leave in droves. There is a new RSA Administration who is now dealing with the difficult task of having to hire numerous new VR Counselors. The fact that there are so many new VR Counselors in this agency means that there are many new Counselors who not familiar with the VR program. This has led to clients’ not receiving services, due to lack of direction from these VR Counselors and to their not making appropriate decisions on behalf of the clients and the services they should be receiving.

CAP staff has observed that most of the VR offices have a majority of new Counselors. Unfortunately, since many of the veteran VR Counselors have left, the new Counselors do not have the experienced Counselors mentors that would help them to be trained on how the VR program works.

CAP staff had met with RSA Administration and discussed that there are way too many VR Counselors who are not receiving the appropriate training to do their jobs properly. RSA Administration agreed and is aware that their new VR Counselors, for the most part, are not experienced. They are trying to find effective strategies to best educate and train these VR Counselors.

j. Interesting cases:

The case of R. F.

RF is an individual with visual and hearing impairments. RF had also formerly worked for Vocational Rehabilitation (VR). RF lost her job with VR, when VR had to lay off certain staff. RF applied for VR services and was initially placed, by her new VR Counselor and with the Supervisor’s approval, in Category 1, which meant she would receive services immediately. When VR Administration realized that RF had been a former staff member of VR, her case was transferred to another Counselor. This Counselor only works with confidential caseloads. Confidential caseloads are VR clients who have formally worked with VR, are currently working with VR, or have families who are VR clients.

When RF started working with this new VR Counselor, who does confidential caseloads, the VR Counselor placed RF in Category 2. Due to the state of Arizona financial issues, VR is under what is known as an Order of Selection. This means that VR can establish a wait list for clients. VR has three categories in which they place their clients depending on the severity of their disability. Individuals placed in Categories 2 and 3 are on a wait list. This means these clients will not receive any services until there are further financial funds available from the State of Arizona. This waiting list has been in existence since the Order of Selection started in 2009. Because RF had been initially placed in Category 1 by the first VR Counselor she applied with and was approved by the Supervisor; she filed for an Administrative Fair Hearing.

The CAP Advocate assisted RF with guidance and helped her prepare for her fair hearing. With the assistance of the CAP Advocate, RF prevailed in the fair hearing and now has been placed in Category 1. Because of the CAP Advocate’s intervention and assistance, RF was immediately provided with VR services. The Case of B.R.

B.R. is a 62-year-old woman who has experienced numerous issues with her VR case. Her case is complicated by the fact that she worked for the Arizona VR Program as a Counselor but was terminated from that position. Her VR case is on the confidential caseload, and she has had to change Counselors several times. Her disabilities include significant learning disabilities and mental illness. She has trust issues with most of the VR staff and vendors involved in her case, and CAP assists her with these by attending IPE planning meetings with her and ensuring that she receives Client Informed Choice in regards to her services. VR initially believed B.R. should only be provided with job development services, using her transferable skills to work as a Peer Mentor in the behavioral health field. CAP has advocated for this client for VR to support her with obtaining additional education, assistive technology, tutoring services, vision therapy and transportation. VR agreed to support B.R. in obtaining a Masters in Social Work. She began this program in the fall but quickly felt overwhelmed and withdrew. CAP is now assisting her to develop a good relationship with a new Counselor and to present a new employment goal to this Counselor.

k. On-line information/outreach:

ACDL has a main website and several social websites. Consumers can visit ACDL’s main website at www.azdisabilitylaw.org. Included on this site are descriptions of CAP, the hours of the STAT intake lines, as well as CAP and ADA guides. All self-advocacy guides are available on the website for immediate viewing and downloading. Our social networking sites provide information on trainings, outreach events, and other topics of vital interest to our clients. For fiscal year 2014, our website had 133,407 total hits.

During this fiscal year, the Center increased our presence on Facebook and Twitter to keep our clients and the general public better informed. Our Facebook site now has 799 followers, increasing by 24% from our followers at the end of last fiscal year. Our Twitter account has 233 followers — a 23% increase from last fiscal year, and we are following 204 individuals, agencies or organizations on Twitter. We are constantly researching innovative methods to get our message to the public who are interested in our services and programs and can further our goals throughout Arizona.

Arizona’s CAP advocates and staff will continue to provide vital information and assistance to consumers through a variety of communication methods.

Certification

Approved

This Report is Complete and Correct.Yes
Date Signed:12-Nov-14
Name of Designated Agency Official:J. J. Rico
Title of Designated Agency Official:Interim Executive Director