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

North Dakota (North Dakota Department of Human Services) - H161A150035 - FY2015

General Information

Designated Agency Identification

NameDivision of Vocational Rehabilitation
Address1237 West Divide Avenue Ste 1A
Address Line 2
CityBismarck
StateNorth Dakota
Zip Code58501
E-mail Addressrcusack@nd.gov
Website Addresshttp://www.nd.gov/dhs/dvr/
Phone701-328-8950
TTY 701-328-6888
Toll-free Phone1-800-755-2745
Toll-free TTY1-800-366-6888
Fax701-328-8969

Operating Agency (if different from Designated Agency)

NameProtection & Advocacy Project
Address400 E. Broadway
Address Line 2Suite 409
CityBismarck
Zip Code58501
E-mail Addresstlarsen@n.gov
Website Addresshttp://www.ndpanda.org
Phone701-328-2950
TTY
Toll-free Phone1-800-472-2670
Toll-free TTY
Fax701-328-3934

Additional Information

Name of CAP Director/CoordinatorTeresa Larsen
Person to contact regarding reportTeresa Larsen
Contact Person Phone701-328-2950

Part I. Non-case Services

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the vocational rehabilitation (VR) program5
2. Information regarding independent living programs1
3. Information regarding American Indian VR Service projects0
4. Information regarding Title I of the ADA0
5. Other information provided1
6. Information regarding CAP2
7. Total I&R services provided (Lines A1 through A6)9

B. Training Activities

a) Rehab Act, VR Services, CAP, transition; b) educate clients and potential applicants along with families and service providers; c) individuals with disabilities, families of individuals with disabilities, service provider staff, new VR counselors, teachers

1. Number of training sessions presented to community groups and public agencies.9
2. Number of individuals who attended these training sessions.159
3. Describe training presented by the staff. Include the following information:
  1. topics covered
  2. purpose of the training
  3. description of the attendees

C. Agency Outreach

Describe the agency's outreach efforts to previously un-served or underserved individuals including minority communities.

CAP staff conducted outreach to the 4 reservations in ND on an ongoing basis. These activities include meeting with Tribal 121 staff. CAP booths were also manned at a Veterans Stand Down.

D. Information Disseminated To The Public By Your Agency

For each method of dissemination, enter the total number of each method used by your agency during the reporting period to distribute information to the public. For publications/booklets/brochures (item 4), enter the total number of documents produced. Agencies should not include website hits. See instructions for details.

N/A

1. Agency Staff Interviewed or Featured on Radio and TV0
2. Articles about CAP Featured in Newspaper/Magazine/Journals0
3. PSAs/Videos Aired about the CAP Agency0
4. Publications/Booklets/Brochures Disseminated by the Agency4000
5. Number of Times CAP Exhibited at Conferences, Community Fairs, etc.9
6. Other (specify below)

E. Information Disseminated About Your Agency By External Media Coverage

Describe the various sources and information disseminated about your agency by an external source.

N/A

Part II. Individual Case Services

A. Individuals served

An individual is counted only once during a fiscal year. Multiple counts are not permitted for Lines A1-A3.

1. Individuals who are still being served as of October 1 (carryover from prior year)26
2. Additional individuals who were served during the year23
3. Total individuals served (Lines A1+A2)49
4. Individuals (from Line A3) 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 A3 above.)1
5. Individual still being served as of September 30 (Carryover to next year. This total may not exceed Line A3.)30

B. Problem areas

Multiple responses permitted.

1. Individual requests information0
2. Communication problems between individual and VR counselor10
3. Conflict about VR services to be provided24
4. Related to VR application/eligibility process12
5. Related to assignment to order of selection priority category0
6. Related to IPE development/implementation
  1. Selection of vendors for provision of VR services
  2. Selection of training, post-secondary education
  3. Selection of employment outcome
  4. Transition services
3
7. Related to independent living services1
8. Other Rehabilitation Act-related problems0
9. Non-Rehabilitation Act related
  1. TANF
  2. SSI/SSDI
  3. Housing
  4. Other:
0
10. Related to Title I of the ADA0

C. Intervention Strategies for closed cases

(Choose one primary service the CAP provided for each closed case file. There may be more case files than actual individuals served.)

1. Short Term Technical Assistance13
2. Investigation/Monitoring0
3. Negotiation7
4. Mediation and other methods of Alternative Dispute Resolution0
5. Administrative / Informal Review0
6. Formal appeal / Fair Hearing0
7. Legal remedy / Litigation0
8. Total20

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.)

N/A

1. All issues resolved in individual's favor15
2. Some issues resolved in individual's favor (when there are multiple issues)3
3. CAP determines VR agency position/decision was appropriate for the individual0
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)1
5. Individual chose alternative representation0
6. Individual withdrew complaint0
7. Issue not resolved in clients favor0
8. CAP services not needed due to individual's death, relocation, etc.0
9. Individual not responsive/cooperative with CAP1
10. CAP unable to take case due to lack of resources0
11. Conflict of interest0
12. Other (Please explain below)

E. Results achieved for individuals

(Choose one primary outcome for each closed case file. There may be more case files than the total number of individuals served.)

N/A

1. Controlling law/policy explained to individual2
2. Application for services completed0
3. Eligibility determination expedited1
4. Individual participated in evaluation1
5. IPE developed/implemented/Services Provided7
6. Communication re-established between individual and other party6
7. Individual assigned to new counselor/office0
8. Alternative resources identified for individual3
9. ADA/504/EEO/OCR complaint made0
10. Other (Please explain below)

Part III. Program Data

A. Age

Multiple responses not permitted.

1. Up to 180
2. 19 - 2411
3. 25 - 4011
4. 41 - 6424
5. 65 and over3
6. Total (Sum of Lines A1 through A5. Total must equal Part II, Line A3.)49

B. Gender

Multiple responses not permitted.

1. Females22
2. Males27
3. Total (Lines B1+B2. Total must equal Part II, Line A3.)49

C. Race/ethnicity of Individuals Served

1. Hispanic/Latino of any race (for individuals who are non-Hispanic/Latino only)1
2. American Indian or Alaskan Native13
3. Asian0
4. Black or African American3
5. Native Hawaiian or Other Pacific Islander0
6. White32
7. Two or more races0
8. Race/ethnicity unknown0

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Acquired Brain Injury2
2. ADD/ADHD0
3. AIDS/HIV1
4. Amputations or Absence of Extremities0
5. Arthritis or Rheumatism0
6. Anxiety Disorder0
7. Autism Spectrum Disorder1
8. Autoimmune or Immune Deficiencies (excluding AIDS/HIV)0
9. Blindness (Both Eyes)0
10. Other Visual Impairments (Not Blind)2
11. Cancer0
12. Cerebral Palsy1
13. Deafness0
14. Hard of Hearing/Hearing Impaired (Not Deaf)1
15. Deaf-Blind0
16. Diabetes0
17. Digestive Disorders0
18. Epilepsy2
19. Heart & Other Circulatory Conditions1
20. Intellectual Disability2
21. Mental Illness17
22. Multiple Sclerosis1
23. Muscular Dystrophy0
24. Muscular/Skeletal Impairment1
25. Neurological Disorders/Impairment0
26. Orthopedic Impairments8
27. Personality Disorders0
28. Respiratory Disorders/Impairment0
29. Skin Conditions0
30. Specific Learning Disabilities (SLD)8
31. Speech Impairments0
32. Spina Bifida0
33. Substance Abuse (Alcohol or Drugs)0
34. Other Disability1
35. Total (Sum of Lines D1through D34. Total must equal Part II, Line A3.)49

E. Types of Individual Served

Multiple responses permitted.

1. Applicant of VR20
2. Individual eligible for VR services currently on a wait list0
3. Individual eligible for VR services not currently on a wait list22
4. Applicant or individual eligible for Independent Living3
5. Transition student/High school student1
6. All other applicants or individuals eligible for other programs or projects funded unther Rehabilitation Act3

Part IV. Systemic Activities and Litigation

A. Non-Litigation Systemic Activities

Governor’s Committee on the Employment of People with Disabilities

The Client Assistance Program is actively involved in the Employment First Initiative in North Dakota. One of the accomplishments of this initiative was to support legislation to restore the Governor’s Committee on the Employment of People with Disabilities. Under the new legislation, the purpose of the Governor’s Committee on Employment of People with Disabilities is to further the goal of considering competitive and integrated employment as the first option when supporting individuals with disabilities who are of working age to obtain employment. Specific focus is on removing and identifying barriers that prevent this from occurring for individuals with disabilities who are of working age to obtain employment. The Protection & Advocacy Project (P&A) holds a position on this committee per legislation. The representative from P&A works part time in the Client Assistance Program. Vocational Rehabilitation also has an appointee to this committee.

The Committee on the Employment of People with Disabilities met four times in 2015 (October 2014—September 2015). In 2015 the committee engaged in information gathering regarding activities of existing employment committees and work groups. Information was also provided to the committee on the Workforce Innovation and Opportunity Act and the State Hiring Initiative being proposed by the State Rehabilitation Council. The committee is working on developing a work plan based on the top goals of the different committees and work groups in order to support an overall unified plan. The committee is providing money for an employment survey through the ND Association of Community Providers. The survey is in the development stage through NDCPD.

State Rehabilitation Council (CAP)

The purpose of the Advisory Council is to advise the Director of the Division of Vocational Rehabilitation concerning policy and program issues, delivery of services to clients, and methods for reaching potential clients. The SRC met four times in 2015 in addition to sub—committee meetings. The Bismarck CAP representative participates on the SRC and is the chairperson of the Public Awareness/Membership Committee. The CAP representative was elected co—chair of the SRC for 2015 and will automatically become the chair for 2016.

During 2015 the SRC has been receiving information regarding the Workforce Innovation and Opportunity Act (WIOA) in preparation for the regulations to roll out. SRC also formed an Ad Hoc committee to begin work on an initiative to promote a Governor’s or State Hiring Initiative for people with disabilities similar to what is imposed for federal agencies. The committee is working to support this effort from the bottom up and has a one year goal to establish language and gather support to move the effort forward.

In 2015 the Public Awareness/Membership committee chaired by the CAP representative, requested that the SRC approve inviting all Tribal 121 Projects to apply for membership to the council. The committee felt that this needed to happen since each Tribal VR is a separate and distinct agency representing a specific tribe and reservation. This request was approved and two of the four Tribal 121 Directors have been appointed to the council at the end of the 2015 program year.

This same committee also has worked to move the council to achieve being fully functioning and fully constituted. For a majority of the year all positions were filled and at least 51% of the members were people with disabilities.

The CAP representative was elected Vice—Chair and will automatically serve as chair in 2016.

Access to ID/DD services

The CAP program/P&A has brought forward the issue of the lack of services for youth ages with ID/DD 18—21 who are no long in school. The current position of the DD Division and Vocational Rehabilitation is that these students need to be covered under IDEA and therefore they need to stay in school until they age out at 21. However, some students have met their graduation requirements and want to move on. CAP/P&A have presented this issue to the Transition Community of Practice and the Governor’s Committee on the Employment of People with Disabilities. As a result, a Task Force was formed to discuss this issue with representatives from CAP/P&A, DD Division, Department of Public Instruction and Vocational Rehabilitation. The DD Division director held firm that the DD Waiver could not cover youth under age 21 because they need to receive services under IDEA. The VR representative stated that VR counselors are to take an application and determine eligibility. However, VR cannot provide Supported Employment Services prior to 18 months from their 21st birthday because they would not be eligible for extended service under the ID/DD waiver until then. VR publically agreeing that they need to take applications from youth under age 21 with ID/DD was a big step forward in efforts to access services for these individuals. The next step is to insure that Supported Employment and other VR services are made available to these youth.

1. Number of non-litigation systemic activities not involving individual representation that resulted in the change of one or more policy or practice of an agency.0
2. Describe the systemic activities conducted by CAP during the fiscal year and its impact on other agency's policies or practices.

B. Litigation

N/A

1. Total number of CAP cases requiring litigation involving individual representation resulting in, or with the potential for, systemic change.
a. Number of cases requiring litigation involving individual representation filed during fiscal year.0
b. Number of on-going cases pending at start of fiscal year (carryover from prior fiscal year).0
c. Number of cases resolved through litigation during fiscal year.0
2. Describe the agency's on-going and completed systemic litigation activities involving individual representation.

Part V. Agency Information

A. Designated Agency

1. Agency Type (select only one option) Internal to the State VR agency
2. Name of designate agencyVocational Rehabilitation - ND Dept. of Human Services
3. Is the designated agency contracting CAP services?Yes
4. If yes, name of contracting agency:Protection & Advocacy Project

B. Staff Employed

Provide a description of all CAP positions (see instructions)

The Executive Director (10% FTE); Dir. of Legal Services (5%); Attorney (50%); Advocate (10%); Advocate (40%); Program Director (in—kind for supervision, as needed)

Part VI. Case Examples

Provide some examples of some interesting cases during the past fiscal year.

Summary 1: Joseph is 56 years of age and lives with his wife. He is legally blind and receives SSDI benefits. Joseph also struggles with depression and anxiety on a daily basis. For employment Joseph works from his home to coordinate a county program. His wife has to help him due to his limited vision and ability to operate his computer. Joseph had an open VR case with an active IPE at the time of this referral. Joseph requested help from CAP because he felt he was being denied Assistive Technology that had been approved in his IPE. Joseph’s VR counselor had initially agreed to purchase a piece of vision technology but later stated that VR could not move forward with the purchase. VR usually purchases AT through a purchase order process in order to link a purchase to a client. Therefore, their expectation is to receive the device and then make an e—payment. In this situation the vendor would not send out the device without payment. VR then determined they could not move forward with the purchase. The CAP advocate worked with VR to research whether VR could pay for the device using the agency’s P—card. The CAP advocate also talked with a current vendor of VR to find out if they could purchase the item and be reimbursed by VR. In the end, VR determined that going through the third party vendor found by CAP was the best option since that would allow them to track the purchase to Joseph. Joseph ultimately received the assistive technology through a third party vendor who then was reimbursed by VR.

Summary 2: Terry is 27 years of age and lives in his own apartment. He has a history of a learning disability, intellectual disability and TBI due to an ATV accident. Terry was referred to CAP by his employment specialist because his VR counselor was refusing to support his chosen vocational goal of becoming a sales assistant at a car dealership. The counselor stated she was denying support for this goal because she felt it was setting him up for failure. She indicated that their psych consult did not feel Terry could do this job due to his TBI. Terry told the CAP advocate that he was going to proceed with a job offer with or without VR support.

The CAP advocate met with the VR counselor to discuss Terry’s choice to pursue the career of working as a sales assistant at a car dealership. The counselor was firm on her position that she could not in good conscious support Terry’s vocational goal choice. The CAP advocate stressed that Terry was going to move forward with or without VR. CAP negotiated an alternative option of using this work site as an assessment under Diagnosis and Evaluation which does not require a plan or a specific vocational goal. The counselor agreed to this option and approved the job coaching for Terry at this work site to identify accommodations, AT and support needed for him to be successful. The job coach assisted Terry for two weeks one on one to complete the training modules for this position. Terry did great in his new position during that two week period. VR is satisfied with the outcome of the evaluation and wrote an IPE supporting the vocational goal.

Summary 3: Curt is a 33 year old gentleman who has a history of substance abuse, mental illness and anger control issues. Since high school Curt has had several employment opportunities that were career oriented. However he lost several jobs due to illegal drug use and for selling drugs. Curt has attempted treatment through two separate facilities but neither worked out. Curt, at the time of this referral, stated he had not used drugs or alcohol for two weeks. He felt he was doing very well. Curt contacted CAP because he was sent a letter stating he was not eligible for VR services because he had "a lack of desire to work". CAP spoke to the VR counselor who indicated he thought there were comments in his file that supported Curt’s lack of desire to work. He also stated that it felt like Curt was just applying for VR services as part of a requirement for another program. CAP stated that it was its understanding that guidance and counseling came after an eligibility determination. CAP informed the VR counselor that Curt has been seeking employment on his own without success which demonstrates the desire to work and a need for support to be successful in securing employment. As a result of CAP services, the VR counselor agreed to take a new application and expedite eligibility. Curt was found eligible within a week and is now working with his VR counselor to identify a vocational goal and develop an IPE.

Summary 4: John is a middle aged farmer who sustained a spinal cord injury in a farm related accident. The resulting paraplegia left John reliant on a power wheelchair for mobility. Due to his injury, John was no longer able to climb the ten to twelve foot ladders used to gain physical access to the farm machinery that he used to plant and harvest his small grain crops with. Accordingly, John felt he had no choice but to discontinue farming and rent out his farm land.

However, after several years, John developed a strong desire to resume farming. He discovered an agricultural manufacturer that sold and installed an elevated lift chair device that could be attached to the bed of his pickup truck. This assistive technology device could be lowered to the ground and lift John ten to twelve feet in the air and allow him to gain physical access to and operate all of his farm machinery once again.

In order to obtain the lift chair, John applied for Vocational Rehabilitation (VR) Services. After VR agreed to help to purchase the device, however, John soon discovered that the purchase agreement did not cover certain essential items as demonstrated in the manufacturer’s video tape. Not included was a remote control device that would allow John to operate the lift chair from the front seat of his pickup truck nor did it provide for the storage unit to house and protect the power wheelchair in the bed of the pickup truck. This storage device protected the power wheelchair from rain and dirt as John drove to and from his fields or to town to acquire necessary supplies for his farming operation.

As a result of the flawed contract, it added thousands of dollars to the original purchase price. At this point, John reached an impasse with VR and he requested Client Assistance Program (CAP) advocacy services and negotiation assistance in order to resolve his VR related concerns.

As a result of CAP services, John’s impasse with VR was resolved to his satisfaction and the essential remote controlled device was acquired and the storage unit issue was resolved. With the acquisition of the truck lift device and essential auxiliary equipment, John has been able to successfully resume his farming career. John noted that that the lift chair worked flawlessly during the last grain harvest.

Certification

Reports are to be submitted to RSA within 90 days after the end of the fiscal year covered by this report. Please be reminded that you can enter data directly into RSA's website via the internet. Information on transmittal of the form is found on pages 19 and 20 of the reporting instructions.

Name of Designated Agency OfficialTeresa Larsen
Title of Designated Agency OfficialExecutive Director
Date Signed12/30/2015