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

Washington (CLIENT ASSISTANCE PROGRAM) - H161A140058 - FY2014

General Information

Designated Agency Identification

NameClient Assistance Program
Address2531 Rainier Avenue South
Address Line 2Rainier Avenue S
CitySeattle
StateWashington
Zip Code98144
E-mail Addressjcap@qwestoffice.net
Website Addresshttp://washingtoncap.org
Phone(206) 721-5999
TTY (206) 721-6072
Toll-free Phone(800) 544-2121
Toll-free TTY(888) 721-6072
Fax(206) 721-5980

Operating Agency (if different from Designated Agency)

NameClient Assistance Program
Address2531 Rainier Avenue South
Address Line 2Rainier Avenue S
CitySeattle
Zip Code98144
E-mail Addressjcap@qwestoffice.net
Website Addresshttp://washingtoncap.org
Phone(206) 721-5999
TTY(206) 721-6072
Toll-free Phone(800) 544-2121
Toll-free TTY(888) 721-6072
Fax(206) 721-5980

Additional Information

Name of CAP Director/CoordinatorJerry Johnsen
Person to contact regarding reportJerry Johnsen or Bob Huven
Contact Person Phone(206) 721-5996

Part I. Agency Workload Data

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the Rehabilitation Act1,261
2. Information regarding Title I of the ADA161
3. Other information provided0
4. Total I&R services provided (Lines A1+A2+A3)1,422
5. Individuals attending trainings by CAP staff (approximate)128

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)41
2. Additional individuals who were served during the year190
3. Total individuals served (Lines B1+B2)231
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. 36

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 favor111
2. Some issues resolved in individual's favor (when there are multiple issues)79
3. CAP determines VR agency position/decision was appropriate for the individual12
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)5
5. Individual chose alternative representation4
6. Individual decided not to pursue resolution14
7. Appeals were unsuccessful0
8. CAP services not needed due to individual's death, relocation, etc.1
9. Individual refused to cooperate with CAP5
10. CAP unable to take case due to lack of resources0
11. Other (please explain)

0

E. Results achieved for individuals

1. Controlling law/policy explained to individual68
2. Application for services completed.17
3. Eligibility determination expedited25
4. Individual participated in evaluation23
5. IPE developed/implemented46
6. Communication re-established between individual and other party36
7. Individual assigned to new counselor/office16
8. Alternative resources identified for individual0
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 under26
2. 22 - 4071
3. 41 - 64112
4. 65 and over22
5. Total (Sum of Lines A1 through A4. Total must equal Line I.B3.)231

B. Gender

Multiple responses not permitted.

1. Female124
2. Male107
3. Total (Sum of Lines B1 and B2. Total must equal Line I.B3.)231

C. Race/ethnicity

1. Hispanic/Latino of any race55
For individuals who are non-Hispanic/Latino only
2. American Indian or Alaskan Native16
3. Asian13
4. Black or African American48
5. Native Hawaiian or Other Pacific Islander9
6. White101
7. Two or more races2
8. Race/ethnicity unknown0

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Blindness (both eyes)12
2. Other visual impairments3
3. Deafness16
4. Hard of hearing7
5. Deaf-blind1
6. Orthopedic impairments22
7. Absense of extremities0
8. Mental illness82
9. Substance abuse (alcohol or drugs)6
10. Mental retardation15
11. Specific learning disabilities (SLD)21
12. Neurological disorders17
13. Respiratory disorders0
14. Heart and other circulatory conditions4
15. Digestive disorders1
16. Genitourinary conditions0
17. Speech Impairments0
18. AIDS/HIV positive0
19. Traumatic brain injury (TBI)17
20. All other disabilities7
21. Disabilities not known0
22. Total (Sum of Lines D1 through D21. Total must equal Line I. B3.)231

E. Types of individuals served

Multiple responses permitted.

1. Applicants of VR Program49
2. Clients of VR Program182
3. Applicants or clients of IL Program5
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 only222
2. Other Rehabilitation Act sources only5
3. Both VR agency and other Rehabilitation Act sources10
4. Employer6

G. Problem areas

Multiple responses permitted.

1. Individual requests information73
2. Communication problems between individual and counselor114
3. Conflict about services to be provided115
4. Related to application/eligibility process27
5. Related to IPE development/implementation49
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/referral0
2. Advisory/interpretational47
3. Negotiation121
4. Administrative/informal review63
5. Alternative dispute resolution0
6. Formal appeal/fair hearing0
7. Legal remedy0
8. Transportation0

Part III. Narrative

Narrative

PART III. NARRATIVE

a. TYPE OF AGENCY (3 — external — nonprofit) The Washington State Client Assistance Program (CAP), the service provider, is a private, non-profit agency. Washington CAP has a board of directors with a majority of members identifying themselves as persons with disabilities. The Governor’s Office has contracted with CAP since the fall of 1998. CAP is external to Washington State Government.

b. SOURCE OF FUNDS The Client Assistance Program is 100% federally funded.

c. BUDGET FOR CURRENT AND FOLLOWING FISCAL YEARS Category Current Fiscal Year 2013-2014 Next Fiscal Year 2014-2015 Wages and Salaries 142,859.00 142,858.00 Fringe Benefits (FICA, unemployment, health I ns) 66,870.00 68,514.00 Materials/Supplies 1,500.00 1,300.00 Postage 550.00 550.00 Telephone 5,250.00 3,800.00 Rent 5,968.00 5,939.00 Travel 18,750.00 18,750.00 Copying 1,200.00 500.00 Bonding/Insurance 2315.00 2,700.00 Equipment Rental/Purchase 0.00 0.00 Legal 500.00 500.00 Indirect 0.00 0.00 Misc. (Training, Contractual, Interpreters) 1,724.00 1,700.00 Total 247,486.00 247,111.00

d. NUMBER OF PERSON YEARS Type of Position Full-time Equivalent % of Year Position Filled Person-years Professional Full-time 2.0 100 2.0 Part-time 0.0 0 0.0 Vacant 0.0 Clerical Full-time 0.0 0 0.0 Part-time 0.0 0 0.0 Vacant 0.0

e. SUMMARY OF PRESENTATIONS MADE Client Assistance Program Staff made the following presentations: • CAP staff presented to 11 General Agency Unit meetings about the CAP process and working with CAP cases (92 staff present). • CAP director presented at 2 New Employee Orientations for the General Agency (40 new staff present). • CAP director met once with the Director of Juvenile Rehabilitation Administration (JRA). • CAP director met with the Director of the General VR Agency 12 times. • CAP director met twice with the Director of the Department of Services for the Blind. • CAP director was co-presenter in 1 rehabilitation law training for the General Agency accessible to 4 separate areas in the state (18 staff present). • CAP director and staff attended 4 State Rehabilitation Council meetings for the Department of Services for the Blind. • CAP staff connected with 4 VRCs who are high school liaisons and made contact between parents, youth, teachers and CAP (9 youth opened CAP cases). • CAP director did outreach to tribal VR programs. • CAP rehabilitation coordinator presented 1 workshop on dealing with people in difficult situations (28 VR staff present). • CAP director attended and spoke at 6 State-Wide Management Team Meetings (SWMT) for the General VR Agency. • CAP director attended six DVR orientation meetings for new VR applicants (director spoke to 54 new applicants and perspective VR clients). • CAP director and staff had 12 individual meetings with The Area Managers of the General VR Agency. • CAP director attended 4 community forums for the State Rehabilitation Council for the General Agency (met with 12 consumers with complaints requiring CAP investigation). • CAP director attended and spoke at 3 State Independent Living Council meetings. • CAP director met with the director of the State Independent Living Council 6 times. • CAP staff attended 3 meetings of the Advisory Group of the Technical Assistance Continuing Education Region X. • CAP staff presented at 2 PAVE workshops for parents and transition youth about the process of moving from FAPE to application, eligibility and participation in VR services as youth further engage in their communities and develop careers (36 parents and 16 youth attended and all followed up with information and referral from CAP staff).

f. ADVISORY BOARDS • CAP director was involved in the local special education department working with transition issues for youth. • The director of CAP serves on the Governor’s State Rehabilitation Council for Vocational Rehabilitation. • The CAP rehabilitation coordinator serves on the Department of Services for the Blind Rehabilitation Council. • The CAP director is an associate member of the Governor’s Committee on Disability and Employment. • The CAP director serves on the ADA Committee for the Seattle Housing Authority. • The CAP director is active in the city PTSA and involved in special education and transition issues. • The CAP director serves as the CAP representative on region 10 TASE advisory committee.

g. OUTREACH TO UNSERVED/UNDERSERVED POPULATIONS CAP staff has begun working with the school-to-work coordinators with the Division of Disabilities Agencies in the two largest counties to connect with both families and their school transition teams. Specific efforts focused on identify youth and their families, providing information and advocacy while school teams interact with Vocational Rehabilitation. CAP staff clarifies the role of the Client Assistance Program as an informational, referral, advocacy, and an access point for VR services. CAP presentations to families involved with PAVE focussed on advocacy and involvement of VR staff on their transition teams. The Blind Agency has been excellent at involving CAP staff in their transition programs. Department of Services for the Blind staff has been able to support more resources to transition-age blind and visually impaired youth, including supporting youth employment experiences and college preparation while still in high school. CAP has been involved with high school interns with low vision and advocates for their families as they begin to exit high school and develop VR plans. Washington CAP maintains individual contacts with vocational and transition service coordinators in the larger school districts. This includes direct contact with public school educators in the school districts as they develop new skill-center models for serving at-risk transition students with disabilities. Along with the VR liaisons, CAP staff has increased efforts to identify youth with 504 Plans in addition to those with Individual Education Plans. CAP staff values partnerships with WorkSource staff. This also increases the opportunity to interact with persons from ethnic and racial minorities. Many of the services offered by WorkSource staff and their partner agencies involve people with disabilities who are traditionally not referred to the VR agencies. Consumers of WorkSource, and WorkFirst partners tend to have disabling conditions at higher rates, and experience patterns of inequitable treatment more than that found in the majority population. Our collaboration with our neighbors in the WorkSource, WorkFirst and Veteran’s Administration programs presents ongoing opportunities for outreach to unserved and underserved persons who are not identified by VR and typically do not obtain information about VR services. The Washington CAP mission and goals do not consider sheltered work as integrated employment opportunities. CAP staff has developed relationships with administrators and workers in the several major sheltered workshops in the state. CAP staff work with these workshops to identify, inform, refer, and advocate for unserved clients who wish to participate in VR services to obtain competitive employment in integrated settings.

h. ALTERNATIVE DISPUTE RESOLUTION Washington CAP philosophy is to, as often as possible, work with clients and VR counselors directly to resolve concerns and complaints. CAP clients benefit from advocacy plans that involve CAP staff providing third-party interpretation and explanation of prevailing policy and law in all aspects of the VR process. CAP staff and clients may plan to involve supervisors in negotiations in such examples as when conflicts in services might be related to staff performance, complaints regarding personalities, or requests for exception to policy. In both the General and Blind Agencies, we have access to all levels of VR administration to review cases when CAP staff and clients request it. At every level of negotiation, administrators are open to resolving conflicts prior to any formal administrative actions. These advocacy strategies offer a resolution process in line with the CAP philosophy to resolve disputes at the levels closest to service provision, starting with the VRC and involving supervisory and administrative staff as needed. CAP staff, at times, request Administrative review to clarify issues and alternatives by using a broader lens to view good rehabilitation process and resolutions. CAP staff continues to provide clients with information as to their rights to alternative dispute resolution and mediation options to resolve VR concerns and conflicts. We inform clients of their right to the appeal process and CAP staff’s ability to work with those whose cases have merit as they bring their issues to fair hearing. In all of our cases this year we have resolved cases at or below administrative review and have not participated in any formal administrative hearings. We do, on occasion, work with clients whose cases either lack merit or who are unwilling to cooperate with both CAP and VR agencies to facilitate a resolution. In such cases we inform the client of her/his rights to request mediation and/or the formal hearing process.

i. SYSTEMIC ADVOCACY Placement of designated State Unit Washington State continues to be out of compliance with CFR 361.13. “ . . . is located at an organizational level and has organizational status within the state agency comparable that of other major organizational units of the agency” The current configuration of WA DVR has the General Agency reporting to Juvenile Rehabilitation Agency not to the director of the designated state agency (DSHS). We have jointly advocated, with the State Rehabilitation Council to RSA, DVR, JRA, and the director of DSHS. DVR and DSHS have been asked for a final response to the RSA request for correction.

Counseling and Guidance CAP believes good counseling and guidance is fundamental to the rehabilitation process and should happen from application to closure. All too often other priorities, (e.g. case movement, communication, agency requirements and priorities, resources, lack of mentoring and training,) overshadow the most important service(s) customers require to be successful. CAP staff advocated jointly, with the State Rehabilitation Council, for DVR to provide more mentoring to both supervisors and direct-line staff about the need for individualized and client-center-thinking in case flow management.

Client Case Transfers Individual client case transfers should never be held hostage because another supervisor or area manager does not like the vocational plan, case is over status, or other current case management issues. VR should be a seamless process and problems within the system should be fixed so clients don’t fall victim to agency internal squabbles. CAP has advocated and provided information on consistency of services and the need to mentor supervisors throughout the state.

Orientation/Application to DVR Services CAP staff members continue to be concerned about how DVR clients initiate their services with DVR. Throughout the state and from office to office the process differs. In many offices clients attend a general orientation conducted by staff but not always by a Vocational Rehabilitation Counselor. If a client decides to pursue services they are given an appointment but again, depending on the office, it may or may not be with a VRC. At each stage of this process there are delays. Clients often are not signing an application until they are 3 to 6 weeks along. Finally, a client meets their VRC. Unfortunately, some clients feel the process is starting again from the beginning, as they have to repeat conversations, provide the same information again, and attempt to form a new relationship with a VR professional. Often, clients have felt they have completed the process, only to find they are again at the beginning. CAP has advocated with the General Agency administration that the most ideal, client-center orientation/application process should be timely, consistent, and should not require clients to meet with several individuals before meeting with their VRC to begin again with signing an application. We do see several offices that model a direct and smooth process for orientation/application.

VRCs pressured by Budgets CAP advocacy has resulted in some systemic changes for VRCs to provide services without feeling limited by overspending their budgets. Systemic changes include advocating that auditors be removed from making rehabilitation decisions based on case review findings and that service decisions are made by unit supervisors and their counselors. Unfortunately, in some areas, staff continues to feel pressure from the culture of their units and area supervisors to consider cost of payment, instead of feeling empowered to provide individualized services best suited to their clients successful VR process.

j. INTERESTING CASES Ongoing Empowerment Emanuel first came to CAP four years ago when his vocational rehabilitation counselor would not support his goal to become a social worker. Instead, he was told he would get help finding a job and then would be able to put himself through school. He asked CAP staff whether he should accept DVR’s “offer” of an AA degree in human services. During his first case with CAP, we made an advocacy plan that included researching the areas of social work he was interested in; finding out job descriptions, and what school programs offered appropriate training. CAP staff advocated for VR to provide Emanuel opportunities to do this research during assessment and before writing the Individualized Plan for Employment. At the time of writing the IPE, the VRC offered a bachelor’s level of training and job placement supports after graduation. Emanuel was told to complete all the financial aid paperwork and come back and write a plan. At this time, CAP advocated for writing an IPE that included a Master’s in Social Work degree. His interests, abilities, capabilities were all guiding him towards fields that required an MSW. However, Emanuel wanted to get on with his training and hoped to find work sooner. He made a choice, and accepted the BSW “offer” from his DVR counselor. While working with CAP advocacy, he learned that vocational rehabilitation was not about the VRC making offers and then accepting what they proposed. He was learning to make decisions involving his rehabilitation process. In the second year of his B.A. program Emanuel came back to CAP discouraged because, from his school experience, he now knew finding satisfying employment with a BSW degree would not be easy, nor would it match his interests and capabilities. He again developed with CAP staff a plan to advocate for amending his IPE services to include an MSW. After some months of negotiation he had his plan amended and was able to focus his undergraduate studies towards moving into the MSW program at his university. He believed his strengths were in the area of research and methodology and this requires an MSW. For the next 2 years, Emanuel sometimes asked a CAP staff person to either plan with him for his meetings with the VRC or to give him feedback on how to respond and negotiate. He was beginning to advocate for himself. He agreed to achieve a 3.0 GPA and worked with the school’s disability services to obtain accommodations. CAP staff advocated for him to attend school part-time to accommodate his disability. Now in graduate school, Emanuel continues to contact CAP staff regularly. What pleases him these days is how he can ask questions from a CAP advocate and bring what he learns to the table with both his VRC and with the school. Emanuel believes what he has learned about advocacy and self-advocacy will make him a better social worker.

Case Closure Don’s VR case was closed based on him getting employment. However prior to his case closure he let his VRC know that he was not getting enough hours in his job and did not want his case closed. When CAP investigated it was confirmed by his VR counselor that Don did object to case closure but the counselor had run out of patience with him and felt Don needed mental health counseling. CAP suggested the closure be rolled back, the case be reopened, and mental health services be explored. Don was adamant that he did not need mental health services, but was willing to go through an evaluation and consider recommendations. Case was reopened.

Inexperienced VRC with a lack of mentoring Eloisse came to DVR asking for help to determine a new career goal. She was already borrowing money to attend a certification program in home health care. Eloisse knew she needed a career change after several years caring for her aging parents. She knew about DVR and wanted to obtain expert counseling and guidance to gain direction, focus, and new skills for re-entering employment and accommodate her anxiety disorder. She believed she was too disabled to return to her previous type of employment. Unfortunately, Eloisse was assigned a new and inexperienced vocational rehabilitation counselor. At their first meeting her VRC told Eloisse DVR would not spend money on training because she already had an advanced degree in business administration and had some spotty work history. The VRC told her many clients wasted DVR money doing well in school but poorly at work. DVR would instead help her find a job that used her prior training - if possible - but the VRC was not sure DVR could help because she had been fired from her last job in 2010. Eloisse came to CAP dismayed that she may never be able to work because her VRC thought her depression and anxiety were too severe to hold down any job. She had already decided to borrow more money to stay in school as she only had 3 terms left and wanted to complete training, even if DVR refused to help. CAP staff reviewed these issues with the VRC who again stated she would not support the cost of more schooling. CAP staff reminded this VRC that VR needed to document the support of a client’s goal, or clear reasons to not support the goal. Costs of service were not the reason to deny a goal. Eloisse and CAP identified the issues as: The VRC was making denials without exploring options; VRC was not considering information Eloisse brought to the table. Examples included: the work she was doing with her own psychiatrist to gain mental health supports; reports from her teachers that she was doing well in school; and several referrals from home health agencies she was working for as a temporary worker. The supervisor needed to be involved in this case. However, the supervisor supported the VRC decisions without reviewing information brought to her from CAP as well as what had already come to the VRC directly from Eloisse. CAP staff advocated with VR administration that Eloisse be supported in her goal and requested a full review of the file, including the information Eloisse had requested the VRC review. Administration overruled the supervisor’s denial and agreed to transfer Eloisse’s case to another supervisor and VRC. Eloisse was reimbursed for the tuition she had been paying while a VR client and worked out an IPE with the new VRC. She finished her Certified Nursing training and is working for a home hospice provider in her community.

k. ON-LINE INFORMATION AND OUTREACH The Client Assistance Program has an interactive Web site at www.washingtoncap.org. • The site can be used with assistive technology as well, including screen enlargement, text-to-speech, and American Sign Language; • Interested persons have the option to complete an online referral form that triggers an email to staff who then contact them for the intake process within one business day; • The site has links to the Rehabilitation Act, The WA State Administrative Code, and the home pages of the General VR Agency (DVR), Department of Services for the Blind (DSB), and the state Rehabilitation Council; • Text is also available in Spanish; • The site can be updated and staff members post fact sheets, news, and events; • The site describes CAP’s non-profit and board structure; • CAP is identified as a program funded by federal dollars under the Rehabilitation Act. The web site tracts demographics; CAP staff track number of hits, and information such as where visitors are located, and their language used. The site averages 220 hits per month, 22 contact requests and 15 completed intake packets for new CAP clients. Most visitors reach the site directly; however, demographics track links back to other websites visitors navigate from. CAP is using electronic networking and contact lists to increase interactive information and referral with providers and consumers and to broaden outreach beyond those reached by mailings, flyers, workshops, site visits, and requests for brochures. Staff respond to requests for information through email, voicemail, and the website on a daily basis. Technology such as smartphones, call forwarding, voicemail, texting and emails increase timeliness and allow CAP staff more effective and efficient opportunities to handle higher volumes of contacts while increasing outreach efforts.

Certification

Approved

This Report is Complete and Correct.Yes
Date Signed:22-Dec-14
Name of Designated Agency Official:Jerry Johnsen
Title of Designated Agency Official:Director