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

Indiana (INDIANA P and A SERVICES) - H161A140015 - FY2014

General Information

Designated Agency Identification

NameIndiana Protection and Advocacy Services
Address4701 N. Keystone Ave.
Address Line 2Suite 222
CityIndianapolis
StateIndiana
Zip Code46205
E-mail Address
Website Addresshttp://www.in.gov/ipas
Phone317-722-5555
TTY 317-722-5563
Toll-free Phone1-800-622-4845
Toll-free TTY1-800-838-1131
Fax317-722-5564

Operating Agency (if different from Designated Agency)

NameIndiana Protection and Advocacy Services
Address4701 N. Keystone Ave.
Address Line 2Suite 222
CityIndianapolis
Zip Code46205
E-mail Address
Website Addresshttp://www.in.gov/ipas
Phone317-722-5555
TTY317-722-5563
Toll-free Phone1-800-622-4845
Toll-free TTY1-800-838-1131
Fax317-722-5564

Additional Information

Name of CAP Director/CoordinatorDawn Adams
Person to contact regarding reportCathy Wingard
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 Act53
2. Information regarding Title I of the ADA0
3. Other information provided72
4. Total I&R services provided (Lines A1+A2+A3)125
5. Individuals attending trainings by CAP staff (approximate)136

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)13
2. Additional individuals who were served during the year22
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.)2

C. Individual still being served as of September 30

Carryover to next year. This total may not exceed Line I.B3. 4

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 favor12
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 individual1
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)3
5. Individual chose alternative representation1
6. Individual decided not to pursue resolution3
7. Appeals were unsuccessful0
8. CAP services not needed due to individual's death, relocation, etc.2
9. Individual refused to cooperate with CAP6
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 individual15
2. Application for services completed.1
3. Eligibility determination expedited2
4. Individual participated in evaluation1
5. IPE developed/implemented8
6. Communication re-established between individual and other party2
7. Individual assigned to new counselor/office2
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 under4
2. 22 - 4013
3. 41 - 6414
4. 65 and over4
5. Total (Sum of Lines A1 through A4. Total must equal Line I.B3.)35

B. Gender

Multiple responses not permitted.

1. Female15
2. Male20
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 Native0
3. Asian0
4. Black or African American7
5. Native Hawaiian or Other Pacific Islander0
6. White26
7. Two or more races0
8. Race/ethnicity unknown1

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Blindness (both eyes)0
2. Other visual impairments1
3. Deafness2
4. Hard of hearing6
5. Deaf-blind0
6. Orthopedic impairments8
7. Absense of extremities0
8. Mental illness6
9. Substance abuse (alcohol or drugs)0
10. Mental retardation2
11. Specific learning disabilities (SLD)5
12. Neurological disorders4
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 disabilities1
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 Program29
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 only35
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 information0
2. Communication problems between individual and counselor0
3. Conflict about services to be provided29
4. Related to application/eligibility process6
5. Related to IPE development/implementation1
6. Other Rehabilitation Act-related problems0
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/referral4
2. Advisory/interpretational18
3. Negotiation7
4. Administrative/informal review0
5. Alternative dispute resolution2
6. Formal appeal/fair hearing1
7. Legal remedy1
8. Transportation0

Part III. Narrative

Narrative

a. Type of agency used to administer CAP: Indiana Protection and Advocacy Services (IPAS) is an external protection and advocacy agency.

b. Sources of funds expended: Federal

Source of funding Total expenditures spent on individuals:

Federal funds: 211,102 (2014 award)

State Funds -0-

All other funds-0-

Total from all sources: 211,102

c. The IPAS budget for the current and subsequent fiscal years.

Current Fiscal Year 2014 /Next Fiscal Year 2015

Wages & Salaries: 63,648 /112,448

Fringe Benefits: 35,587 /56,224

Materials/Supplies: 383/1,521

Postage: 620/1,236 Telephone: 1,699/3446 Rent: 5,945/7000 Travel: 4,000/8,081 Copying: 1,359/2,283 Bonding/Ins: 394/855 Equipment Rental/Purchase: 2,320/4,283 Legal Services: 0/2,000 Indirect: 0/0 Misc: 7,111/10,867 Total Budget: 123,071/210,248

d. Number of person-years:

Type of position Full-time equivalent % of year position filled Person-years:

Type of position Full-time equivalent % of year position filled Person-years Professional 1.23 100% 17 Full-time 1.23 100% 17 Part-time N/A Vacant 0.04 50% 1 Clerical 0.18 100% 4 Full-time 0.18 100% 4 Part-time N/A Vacant 0.04 90% 1

The IPAS Executive Director position was vacant for half of the year. One clerical staff retired this year.

e. Summary of presentations made: During the year, the Client Assistant Program (CAP) advocates presented information about our services at nine education/training events and thirteen public information activities reaching approximately 16,218 individuals. These presentations and exhibits targeted transitioning youth, rural and metropolitan areas of the state, newly-hired Vocational Rehabilitation (VR) Counselors, Rehabilitation Services Commission members, staff and council members of the Indiana Independent Living Centers (CIL), and specific disability organizations and groups. Presentations: 1/22/1014-Accessibility (CIL)-12 10/17/2013-ATTIC (CIL)-6 10/15/2013-SICIL (CIL)-6 01/02/2014-Gary West VR-5 10/9/2013-Gary East VR-6 12/20/2103-Muncie VR-7 01/03/2014-Indiana APSE conference-143 O3/01/2014-Inspriring Abilities Expo Transition Fair-100 06/30/2014-Mooresville School Transition Fair-100 09/24/2014-Bishop/Chatard High School Transition/Parent Night-53

There was also over 100 additional agency-wide education/training/presentations and public information/exhibit activities introducing IPAS services including CAP to approximately 25,324 individuals. In addition to the listed presentations and exhibits, the following numbers of informational brochures and newsletters were distributed this year: CAP Brochures-2307 Developmental Disability Network Brochure-875 IMPACT Newsletter - Annual Report-544 IMPACT (agency-wide priorities and objectives) Newsletter-1105 IPAS Agency Booklet-223 IPAS Agency Brochure-4345 Segregated and Exploited: The Failure of the Disability Service System to Provide Quality Work (National Disability Rights Network publication)-55 Toll Free Resource Guide-2250 Transition Planning Handbook-A Checklist for Parents of Children with Disabilites-4278 Total number of brochures/newsletters: approximately 16,000 (IPAS brochures and publications are available on a CD as an alternative format and in Spanish.) Future planned activities in this area include a CAP presentation at the next statewide VR Supervisor gathering to present an overview of IPAS and CAP to be included in VR’s Leadership Academy learning modules for new counselors.

f. Involvement with advisory boards: Indiana’s Commission on Rehabilitation Services is the advisory board for Indiana Vocational Rehabilitation (VR) Services, which serves thousands of citizens with disabilities each year through vocational rehabilitation, employment, education and independent living in the community. The CAP Program Coordinator had a consistent presence on the VR Commission this year as well as chairing the policy oversight, planning, and evaluation committee. This committee has become more involved and vocal as new members have joined and newer members have learned more about the rehabilitation process. The Commission is to provide advice to VR and to be the consumer’s voice. During this year, VR has moved forward on all of the initiatives it has presented to the Commission, which included more focus on the transitioning youth, a review of sheltered workshop programs and services, goal setting per the fiscal five-year plan to draw down more federal dollars, creation of new VR case coordinators positions, appointment of a new Director of Field Operations, review of rule promulgation committee reports and other input, evaluation of quality assurance measures and rate reform for the community rehabilitation programs, and the rolling out of a new and improved VR case management system. The CAP Program Coordinator and IPAS staff attorneys participated in policy promulgation work groups and provided input on these proposed draft policies. The Commission sub-committee was consulted throughout this process as well. A CAP advocate serves as a member of the Indiana Council on Independent Living (ICOIL). The ICOIL Coordinator position is vacant and will be filled by the Bureau of Rehabilitation Services (BRS). BRS has been developing a job description and taking applications for this position since the contract of the previous Coordinator expired earlier this year. The council has remained active by providing training to Council members on the independent living movement and the council by-laws. The primary focus of the ICOIL for the year was the completion of the State Plan for Independent Living. The ICOIL has made little progress in achieving any of its goals due to the absence of a Coordinator. The CAP program continues to encourage Independent Living Centers and the Council, via ongoing educational presentations, to refer individuals to IPAS and CAP as needed and inform them of their right to CAP services. The CAP program is also represented with membership on the Indiana Brain Injury Association’s (BIAI) Leadership Board. CAP was invited to remain as a member of the board when the Indiana Department of Correction (IDOC) was awarded the next four year grant from the U.S. Department of Health and Human Services-Health Resources and Services Administration (HRSA) to assist individuals with brain injuries who are exiting the prison system as they transition back into their community and seek employment. BIAI and IPAS have been long-time partners in advocating for those with traumatic brain injury. g. Outreach to unserved/underserved populations: During fiscal year 2014, there were a number of agency presentations to individuals that reside in nursing homes and to individuals who work in approximately fifty-two sheltered workshops or “facility-based work centers”. Both populations are viewed as underserved in Indiana. IPAS surveyed thirteen of the aforementioned work centers where approximately 3,375 people are employed, with 2400 of those workers being people with disabilities. IPAS discovered that not all of the facilities had specific policies in place to address consumer needs for workplace accommodations or assistive technology. Most of the facilities did have policies requiring training to ensure safe work environments. The employees of the work centers reported that they were offered choices in the work that they perform, although sometimes they were not given choice when they worked on contracts that needed to be completed within a certain time frame. Some clients reported that they were working in community-based employment, at least part-time. Many of the employees interviewed said that they knew about Indiana VR and several facilities had VR offices on site. All of the workshop programs had handbooks that described client rights, grievance process, pay, safety, drug screening, dress code and code of conduct. The surveys included interviews with approximately 65 clients. Most of the clients reported that they enjoyed their jobs but would like to earn higher wages. Sub-minimum wages paid at the workshops ranged from $00.01/hour-$7.25/hour. Several of the programs reported they had been awarded federal contracts and were aware of the changes in the federal minimum wage in 2015. The facilities reported that only fourteen individuals "graduated" from their sub-minimum jobs to jobs in the community in the last year. This project will end on December 31, 2014. Throughout the duration of project, IPAS has shared survey results with VR and with the Indiana Association of Rehabilitation Facilities (INARF). At the conclusion of this project, IPAS will provide a comprehensive report to VR and INARF with the findings of the surveys and recommendations. IPAS also continued its outreach to other underserved populations serving individuals with mental illness in comprehensive mental health centers and state-operated hospitals to increase awareness of IPAS and CAP services and to increase referrals. Twice this year, information about CAP was provided to attendees of the rehabilitation program for the blind and visually impaired. Outreach was also provided to individuals affected by domestic violence and sexual assault. Both of these populations are considered to be underserved populations in our state.

IPAS also authored five articles addressing accessibility, treatment, etc in five written articles that were printed in various publications, released four statements to the press about various disability rights issues, and conducted three webinars about Indiana special education law. These outreach formats also reached unserved and underserved populations.

h. Alternative dispute resolutions: CAP represented two individuals through the mediation process this year. In one, a mutually acceptable solution was reached by both parties and services resumed. In another, the client chose to proceed to hearing without CAP representation after the mediation process failed to resolve the dispute. CAP reviewed issues involving eligibility determination, service provision, and choice. CAP advocates also explained controlling law and policy to individuals and negotiated resolutions with the VR counselors. Two individuals were offered and provided CAP legal representation through the appeal process. Sixteen individuals requested that CAP review their VR employment plans this year. Of these, seven issues were resolved by negotiating with VR to resolve the issues. This represents a nearly 50% success rate in advocating the best interest of the client. Case Example: “Peter” called CAP and said that VR had closed his case, that he was appealing this closure and requested CAP assistance through the appeal process. A thorough fact finding was conducted and the CAP advocate found that VR failed to thoroughly assess Peter in terms of his interests, skills, abilities, and preferences as it pertained to the development of his employment plan. The advocate also found evidence of a lack of VR guidance and counseling provided to the client by VR. The client accepted CAP representation through the mediation process. CAP advocated that VR reopen the closed VR case, obtain further career and neuropsychological testing, and develop with the client an employment plan that included an employment goal of his informed choice. The mediation process was successful in that the client’s case was reopened and VR and the client agreed to the other written terms of the mediation. Due to CAP involvement, there was no need for an administrative hearing as all issues were resolved and later the client received the necessary services to reach his chosen employment goal. Below are narratives that best reflect CAP’s continuing efforts at negotiating on behalf of individuals with disabilities: “Joe” called CAP and said he wanted assistance to appeal VR’s refusal to reopen his service case. An advocate was assigned to review Joe’s previous Individual Plan for Employment (IPE) to determine if VR had provided him with all of the necessary services to reach his employment goal, prior to case closure, and to assure that VR was not violating his rights by denying him any necessary services. The advocate contacted the VR Supervisor about Joe’s complaint and learned that the client had worked with VR in the recent past and had obtained employment with VR assistance. VR closed his case because he obtained employment. One of the services provided previously by VR and included in his IPE was an orthopedic mattress. VR had purchased a specialized mattress for Joe that was necessary to overcome a barrier caused by his physical disability but it was not the type that had been recommended by his doctor. The advocate was able to intervene and after informally speaking to the VR Supervisor about the issue, VR agreed to reopen Joe’s case so that they could provide Joe with the appropriate and recommended mattress. “Dean” requested assistance from CAP because VR required him to meet with a small business consultant prior to providing any financial assistance towards his small business enterprise start up costs. CAP fact finding revealed that Dean’s small business plan had already been submitted, reviewed by a committee and approved by VR. The VR policy did not require that he meet with a small business consultant. Due to CAP involvement, VR reversed this decision and agreed to support Dean’s small business enterprise and services were expedited to our client.

i. Systemic advocacy: The IPAS legal team continues their collaboration with Indiana ACLU to assure that the VR policies and procedures are soon promulgated to meet all requirements of the Administrative Rules and Procedures Act (ARPA). The IPAS CAP Program Coordinator met several times this year with the VR Director and the VR Policy and Due Process Director for an update about the ongoing rule promulgation activities. The rules are in draft form at this time and VR believes it has made a "good faith" effort in the promulgation process. VR will meet with the Indiana Attorney General’s Office and their legal staff to review the draft rules before submission, per the written settlement agreement with Indiana ACLU (Roberts v. Indiana Family and Social Services Administration-Marion Superior Court, filed 2/13). Judicial Review Petition: IPAS is representing a client in his appeal of the denial of educational financial assistance by VR. VR adopted a new process and calculation for determining the upper limit of financial assistance/need for post-secondary educational expenses in late 2011 without issuance of a new or amended policy or procedure. The primary argument is that the Policy and Procedure Manual (PPM) used by VR meets the Indiana common law definition of a “rule,” is subject to ARPA and its rule-promulgation provisions; that the PPM has not been promulgated; and therefore, under ARPA, the PPM is void. Based on the settlement reached in October 2013, through which IPAS’s client was reimbursed for his educational expenses as provided for in his Individual Plan for Employment (IPE), VR has now agreed to promulgate its entire PPM as a whole, rather than in parts over an extended period of time. Towards that end, VR convened work groups to review, amend, and compile the PPM to be promulgated. These groups included several CAP advocates and other stakeholders. VR has stated that it is approaching the end of the compilation process and is assembling the revised PPM to be proposed for adoption under ARPA. Indiana ACLU counsel for the class members has stated that VR has targeted October, 2014 to have the PPM ready for filing of notice to rule-make, which is the first step in the promulgation process. The case will remain open based on the fact that IPAS’s client is one of the named plaintiffs in the class action. IPAS will close the case upon of the resolution of the class action claim through completion of promulgation of the PPM. Judicial Review Petition: IPAS is representing a client in the judicial review of VR’s denial of replacement hearing aids. The Administrative Law Judge determined that the client did not qualify for replacement hearing aids because the client did not have a substantially revised prescription, the client continued to have the same job duties, and was not being threatened with job loss. The client’s initial judicial review petition resulted in the case being remanded to VR, and subsequently VR again denied the client’s requested services. A second judicial review petition was filed and the record from the second administrative denial has been filed with the Court. This case, like the aforementioned case, was also included in the PPM promulgation class action. The parties agreed to a settlement agreement where the client received specific relief and received hearing aids. Administrative Hearing: IPAS has agreed to represent a client on an issue involving denial of educational assistance (tuition and books) for the Fall 2013 semester. VR declined to settle the individual reimbursement issue. The administrative hearing for this case is now indefinitely continued pending the resolution of the class action in which the promulgation of VR’s policy continues. IPAS cannot begin a separate litigation using the “Administrative Rules and Procedures” promulgation argument while the promulgation issue remains open and formally unresolved in the class action.

k. On-line information/outreach: On-line: The IPAS website, www.in.gov/ipas, received 69,400 page views during the past fiscal year. Webpage visits totaled 38,570 and web site visitors totaled 34,320. This is an increase from last year. IPAS saw 52 visitors to our website via visits to our Facebook account. The IPAS website is contains valuable information about our programs including CAP and is kept updated by agency support staff. The IPAS Twitter account also saw a significant rise in comments. The monthly IPAS E-newsletter now has a distribution list totaling 471 addresses. Outreach: CAP intake specialists and advocates fielded approximately 136 information and referral calls this year. Satisfaction surveys were sent to each person who received CAP services. These questionnaires provide individuals with an opportunity to comment specifically about CAP services. Five individuals completed and returned surveys this year. Responses indicated a 100% satisfaction with regard to the services that were agreed upon and prompt return of phone calls by the advocate. All indicated that they would contact CAP again if they needed assistance.

j. Interesting cases: “Doris” had a hearing impairment and applied to VR. Doris asked VR for financial assistance for new hearing aids. VR sent her for a hearing assessment which indicated that her hearing had not changed significantly since the last time she was evaluated three years ago. Doris was employed and had purchased hearing aids for herself in the past. These hearing aids were no longer meeting her needs on the job. VR reviewed her application and her request for hearing aids and decided to apply their rules for “replacement hearing aids” as a basis for denying Doris services. VR policy prohibits the provision of replacement hearing aids, to individuals who have received this service from VR in the past, unless the person has experienced further hearing loss or their job duties change. As a result, even though Doris could show that she had an impediment to employment based on struggling with several communication requirements of her job, VR still found her ineligible because she did not have a substantial change in her hearing loss. CAP intervened and pointed out that Doris met the standard for the provision of new hearing aids as she was unable to perform certain job functions due to hearing loss and VR had never purchased hearing aids for her. She met the specific hearing aid provision requirements per state VR policy. The CAP advocate was able to negotiate with VR prior to an administrative hearing. They found Doris eligible for their services, assessed her needs, and provided her with hearing aids. “Eugene” contacted CAP because he believed VR was delaying services as agreed to in his IPE. After a thorough review of the documentation, the CAP advocate determined that the initial services specified in the client’s IPE were indeed being provided. CAP also obtained information during fact finding that indicated that Eugene’s medical condition had changed. CAP advocated for VR to obtain additional assessments of Eugene’s work environment, his home modification needs, and his medical status. Based on the new information obtained from these assessments, CAP then advocated for VR to provide a chair lift and other services to enable Eugene to access his second-floor home office. Eugene can now work from his home. “Sally,” an individual with a hearing impairment, contacted CAP because VR had refused to provide the type of specialized hearing aids she needed to continue to work as a professional musician. Fact finding revealed that VR had provided Sally with several types of hearing aids to use on a trial basis to establish which type might best fit her needs. Sally tried several models of hearing aids and found one brand that performed better for her on the job. However, the hearing aids that worked the best for her were not on the VR “approved” hearing aid vendor list to purchase. VR denied her request for these hearing aids. CAP determined that this denial contradicted the Federal Rehabilitation Act and agreed to assist Sally in appealing the decision. Prior to the hearing, VR reversed its previous decision and provided Sally with the hearing aids that she needed to continue in her occupation as a professional musician. “Karl”, a 19-year-old individual diagnosed with a mental illness, called CAP for assistance. He had never worked before and wanted a job so he applied to VR for assistance with finding employment. VR decided that Karl was not eligible for VR services because his disability was too severe for him to benefit. Karl asked CAP for assistance to appeal the VR decision. Fact finding revealed that VR had not completed a Trial Work Experience (TWE) to allow Karl to demonstrate his ability to work. A TWE is a tool available to VR Counselors that allows them to explore the individual’s abilities, capabilities, and capacity to perform work in realistic work situations. The experience can assist a VR counselor in determining whether or not there is clear and convincing evidence to support the counselor’s severity determination. CAP successfully negotiated for VR to reopen Karl’s case and to obtain the TWE that would enable VR to better understand Karl’s skills and abilities. Karl was given an opportunity to demonstrate his strengths and abilities through a work experience.

“Kyle” contacted CAP because he was not able to communicate effectively with his VRS Counselor, which he believed, was preventing him from reaching his employment goal. Fact finding revealed that Kyle’s disabilities resulted in significant problems with reading. Kyle’s VR counselor was deaf and communicated primarily through written texts. CAP successfully negotiated for the provision of multiple services to address Kyle’s other barriers to employment. These included tutoring services, taking tests with accommodations and accessing mental health counseling services near his home. However, even after amending Kyle’s employment plan to include these services, Kyle and the VR counselor continued to have communication difficulties. IPAS then successfully advocated for VR to transfer Kyle’s case to a different VR counselor. As the result of CAP intervention, Kyle began receiving the VR supports that he needed so he could reach his employment goal.

Certification

Approved

This Report is Complete and Correct.Yes
Date Signed:11-Dec-14
Name of Designated Agency Official:Catharine M. Wingard
Title of Designated Agency Official:Assistant Director of Client Services