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

Tennessee (Disability Rights Tennessee) - H161A170043 - FY2017

General Information

Designated Agency Identification

NameDisability Rights Tennessee
Address2 International Plaza
Address Line 2Suite 825
Zip Code37217
Website Address
TTY 615-298-1080
Toll-free Phone1-800-342-1660
Toll-free TTY1-800-342-1660

Operating Agency (if different from Designated Agency)

NameDisability Rights Tennessee
Address2 International Plaza
Address Line 2Suite 825
Zip Code37217
Website Address
Toll-free Phone1-800-342-1660
Toll-free TTY1-800-342-1660

Additional Information

Name of CAP Director/CoordinatorLisa Primm
Person to contact regarding reportAnna Bass
Contact Person Phone615-298-1080

Part I. Non-case Services

A. Information and Referral Services (I&R)

Multiple responses are not permitted.

1. Information regarding the vocational rehabilitation (VR) program17
2. Information regarding independent living programs0
3. Information regarding American Indian VR Service projects0
4. Information regarding Title I of the ADA0
5. Other information provided2
6. Information regarding CAP11
7. Total I&R services provided (Lines A1 through A6)30

B. Training Activities

Disability Rights Tennessee (DRT) utilized training to increase awareness of CAP scope of services; address Vocational Rehabilitation (VR) personnel gaps in knowledge of CAP; collaborate with key disability stakeholders in Tennessee's statewide efforts to establish competitive, integrated employment; and provide rights and resource education about employment and careers to students with disabilities and their families. As presenters at the Tennessee Works Think Employment Summit and Employment First Taskforce we reached approximately two-hundred self-advocates, employers, educators, families of individuals with disabilities, agencies that provide services to individuals with disabilities, policy makers, and individuals with disabilities. DRT presented about Supported Decision -Making or other alternatives to conservatorship with the goal of increasing awareness regarding individuals with disabilities ability to make informed decisions regarding work. Twenty-one blind and deaf students participated in training focused on using pre-employment transition services to develop self-advocacy skills that will help students secure and maintain employment. These students also received training that shared how Vocational Rehabilitation and CAP can assist while the students are pursing future employment goals. In addition to these efforts with people with disabilities, family members, and community service providers, DRT provided training sessions focused on improving CAP visibility and relationships within VR across the state. Presentations were conducted during new VR counselor training with forty-three new VR counselors receiving this training. Further training was completed across the state with approximately one-hundred and twenty additional VR counselors and administration on the following topics: defining reasonable accommodations in the workplace; teaching self-advocacy skills; asking for accommodations; deadlines for filing complaints; contacting CAP; using pre-employment transition services to create a funnel to VR; and embracing the value of training youth prior to VR application process. DRT is working to implement policy and system changes that make competitive employment the first and desired choice for every Tennessean with disabilities.

1. Number of training sessions presented to community groups and public agencies.8
2. Number of individuals who attended these training sessions.291
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.

DRT remains committed to reaching underserved/unserved populations within Tennessee. During this year, fifty-percent of all employment and CAP focused outreach efforts were targeted toward these populations. These outreach activities primarily focused on rural populations, ethnic and racial minorities, homeless individuals, low socio-economic class communities, and individuals who are deaf. These fifty-two outreach efforts resulted in over thirteen thousand individuals receiving information and has the potential to reach over five thousand individuals with disabilities in these communities. DRT continues to prioritize efforts within the deaf, Hispanic, and Latino communities. Staff are fluent in Spanish and American Sign Language which allows for direct outreach in many situations. Within this fiscal year, significant efforts were made to make agency materials accessible to Tennesseans whose primary language is Spanish.

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.

1. Agency Staff Interviewed or Featured on Radio and TV3
2. Articles about CAP Featured in Newspaper/Magazine/Journals1
3. PSAs/Videos Aired about the CAP Agency0
4. Publications/Booklets/Brochures Disseminated by the Agency4424
5. Number of Times CAP Exhibited at Conferences, Community Fairs, etc.28
6. Other (specify below)0

E. Information Disseminated About Your Agency By External Media Coverage

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

Not applicable

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)21
2. Additional individuals who were served during the year30
3. Total individuals served (Lines A1+A2)51
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.)0
5. Individual still being served as of September 30 (Carryover to next year. This total may not exceed Line A3.)8

B. Problem areas

Multiple responses permitted.

1. Individual requests information0
2. Communication problems between individual and VR counselor12
3. Conflict about VR services to be provided34
4. Related to VR application/eligibility process1
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
7. Related to independent living services0
8. Other Rehabilitation Act-related problems1
9. Non-Rehabilitation Act related
  1. TANF
  3. Housing
  4. Other:
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 Assistance10
2. Investigation/Monitoring6
3. Negotiation25
4. Mediation and other methods of Alternative Dispute Resolution0
5. Administrative / Informal Review0
6. Formal appeal / Fair Hearing0
7. Legal remedy / Litigation0
8. Total41

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.)

1. All issues resolved in individual's favor26
2. Some issues resolved in individual's favor (when there are multiple issues)8
3. CAP determines VR agency position/decision was appropriate for the individual6
4. Individual's case lacks legal merit; (inappropriate for CAP intervention)2
5. Individual chose alternative representation0
6. Individual withdrew complaint2
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 CAP0
10. CAP unable to take case due to lack of resources0
11. Conflict of interest0
12. Other (Please explain below)0

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.)

1. Controlling law/policy explained to individual19
2. Application for services completed0
3. Eligibility determination expedited0
4. Individual participated in evaluation2
5. IPE developed/implemented/Services Provided20
6. Communication re-established between individual and other party2
7. Individual assigned to new counselor/office1
8. Alternative resources identified for individual0
9. ADA/504/EEO/OCR complaint made0
10. Other (Please explain below)0

Part III. Program Data

A. Age

Multiple responses not permitted.

1. Up to 180
2. 19 - 246
3. 25 - 4015
4. 41 - 6427
5. 65 and over3
6. Total (Sum of Lines A1 through A5. Total must equal Part II, Line A3.)51

B. Gender

Multiple responses not permitted.

1. Females28
2. Males23
3. Total (Lines B1+B2. Total must equal Part II, Line A3.)51

C. Race/ethnicity of Individuals Served

1. Hispanic/Latino of any race (for individuals who are non-Hispanic/Latino only)2
2. American Indian or Alaskan Native0
3. Asian0
4. Black or African American19
5. Native Hawaiian or Other Pacific Islander0
6. White28
7. Two or more races0
8. Race/ethnicity unknown2

D. Primary disabling condition of individuals served

Multiple responses not permitted.

1. Acquired Brain Injury1
4. Amputations or Absence of Extremities0
5. Arthritis or Rheumatism0
6. Anxiety Disorder1
7. Autism Spectrum Disorder2
8. Autoimmune or Immune Deficiencies (excluding AIDS/HIV)0
9. Blindness (Both Eyes)1
10. Other Visual Impairments (Not Blind)5
11. Cancer0
12. Cerebral Palsy2
13. Deafness1
14. Hard of Hearing/Hearing Impaired (Not Deaf)4
15. Deaf-Blind0
16. Diabetes0
17. Digestive Disorders0
18. Epilepsy0
19. Heart & Other Circulatory Conditions2
20. Intellectual Disability3
21. Mental Illness13
22. Multiple Sclerosis0
23. Muscular Dystrophy0
24. Muscular/Skeletal Impairment1
25. Neurological Disorders/Impairment1
26. Orthopedic Impairments8
27. Personality Disorders0
28. Respiratory Disorders/Impairment0
29. Skin Conditions0
30. Specific Learning Disabilities (SLD)4
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.)51

E. Types of Individual Served

Multiple responses permitted.

1. Applicant of VR5
2. Individual eligible for VR services currently on a wait list0
3. Individual eligible for VR services not currently on a wait list46
4. Applicant or individual eligible for Independent Living0
5. Transition student/High school student0
6. All other applicants or individuals eligible for other programs or projects funded unther Rehabilitation Act0

Part IV. Systemic Activities and Litigation

A. Non-Litigation Systemic Activities

Systemic Activities with Tennessee Rehabilitation Services:

DRT’s CAP was once again represented on the State Rehabilitation Council (SRC), with our representative playing a key role as secretary of the SRC. Our representative was highly involved in preparation of the VR/SRC Annual Report, which was submitted to the governor, and also represented the SRC on the bi-monthly national conference calls of the National Coalition of State Rehabilitation Councils. In January the SRC participated in a roundtable held by VR leadership to generate ideas for potential changes to post-secondary training. During the fiscal year, VR also presented five draft policies related to VR services to the SRC for review and comment. DRT’s CAP representative organized the review processes and prepared comments for submission to VR, and it was noted that VR utilized many of the SRC suggestions. The SRC was also involved in RSA’s monitoring of Tennessee VR, meeting with RSA to discuss its focus areas. DRT has identified service delivery structure and implementation of Pre-employment Transition Services (Pre-ETS) as an important area to focus our systemic efforts. DRT worked collaboratively with the Department of Education to advocate for collaboration of transition services between VR and the Department of Education and data collection. DRT also advocated for more informed choice for Pre-ETS clients. DRT developed a Pre-ETS flyer to distribute to potential clients and an educational letter to send out to the school systems, and the Department of Education helped us distribute both in print and on the web. DRT also provided training on Pre-ETS to VR counselors and outreach and information to potential clients at regional transition fairs. DRT’s employment task force provided comments at four public hearings across the state on VR proposed policy changes in the areas of Customized Employment, Supported Employment, Pre-ETS, and Self-Employment. DRT’s comments on these topics were also provided in written form to VR leadership and the RSA contact for Tennessee. DRT also attended regional VR Vendor Forums throughout the fiscal year to stay abreast of changes regarding Letters of Agreement and grant processes for Community Rehabilitation Providers. DRT also provided written comments to RSA regarding RSA’s monitoring of VR. DRT reached out to the new Commissioner over VR to share concerns and renew collaborative efforts between VR and DRT, including the resumption of quarterly collaborative meetings. One productive collaborative meeting was held in FY 2017. Systemic concerns were discussed, VR provided information regarding new initiatives, and DRT shared information from its survey of VR staff and discussed options for addressing the need for additional CAP information to be provided to VR staff. As a result, VR leadership has agreed to work with DRT to produce a webinar for counselors regarding CAP services and has also added CAP information to more of the VR forms which are regularly provided to clients so that clients receive CAP information at multiple points of case service as required by federal regulations. Finally, DRT’s CAP accepted VR’s invitation to participate and provide information at regular quarterly meetings held with Community Rehabilitation Providers across the state beginning in FY 2018.

Other Systemic Employment Activities

DRT helped plan, exhibited at, and facilitated breakout sessions at the bi-annual transition conference hosted by Knox County Schools. As an exhibitor, DRT had the opportunity to share information about transition, including information about the assistance we provide to VR clients and applicants via CAP. DRT also participated in monthly and quarterly Employment Consortium meetings with key stakeholders in Middle and East Tennessee in order to increase the amount of individuals with disabilities employed in competitive integrated settings. The Knoxville Area Employment Consortium sponsored its annual Disability Mentoring Day and Disability Awareness Breakfast during Disability Employment Awareness Month in an effort to highlight employment of individuals with disabilities. The Knoxville Area Employment Consortium also continued its strong involved in specific initiatives designed to increase competitive employment of Knoxville-area individuals with disabilities and hosted a second Community Conversation. The Tennessee Works Partnership, comprised of 28 partner agencies, engages in activities designed to promote systemic changes that will lead to increased competitive integrated employment for youth with intellectual and developmental disabilities. DRT’s active participation in this partnership in FY 2017 included work on training web modules for teachers and students to improve transition services for students with disabilities. These modules are currently available and being used by teachers and students across the state so that students with disabilities will be more likely to successfully transition from school to community and work. DRT also participates in the Governor-created Employment First Task Force, which includes state agencies, nonprofits, universities, service providers, and Tennesseans with disabilities and their families. This fiscal year the Employment First Task Force presented its third annual Expect Employment Report to the Governor, which touted its accomplishments of the year, including the launch of an Individual Placement and Supports program in four community health centers, a revised VR service agreement to create stronger incentives for vendors to achieve employment outcomes, implementation of Project SEARCH at two new sites, updated policies at several state agencies, commencement of Medicaid waiver revision to support employment as a first option, and work on a Memorandum of Understanding between five state agencies to improve data collection and align goals, priorities, and resources for transitioning 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.29
2. Describe the systemic activities conducted by CAP during the fiscal year and its impact on other agency's policies or practices.

B. Litigation

Not Applicable

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) External-Protection and Advocacy agency
2. Name of designate agencyDisability Rights Tennessee
3. Is the designated agency contracting CAP services?No
4. If yes, name of contracting agency:N/A

B. Staff Employed

Provide a description of all CAP positions (see instructions)

Type of Position FTE/ % of year filled/Person—years Professional 12/100%/12 Full—time 11/100%/11 Part—time 1/100%/1 Vacant 0 Clerical 6/100%/6 Full—time 6/100%/6 Part—time 0 Vacant 0

Part VI. Case Examples

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

After receiving DRT’s assistance, an individual reported that, for the first time as a VR client, her post-secondary training-related services were paid prior to the beginning of the semester and she did not experience delays in working with VR. She was relieved to begin her final semester of college without concerns about payment for services and was able to focus on her studies to obtain her bachelor's degree in social work. This individual, a 55-year-old African American female from an urban area with orthopedic disabilities, had repeatedly been forced to take out student loans to pay necessary educational fees due to late and inaccurate payment of her tuition and associated post-secondary training-related services by VR. DRT reviewed all documentation and discussed our client's concerns with the VR regional supervisor. The regional supervisor’s investigation found that VR had misunderstood part of the information received from the college’s financial aid office. VR worked with the client and DRT to amend the client's IPE and correct documents to accurately reimburse the client's university account. VR also addressed issues with delays in processing the purchase orders for providing transportation funds to our client. A follow-up with our client after the beginning of the following semester showed that appropriate tuition, fees, books, etc. were paid by VR in a timely manner. DRT assisted an individual whose hearing aids were no longer functional and was relying on loaner hearing aids intended only for short-term use. She was having difficulty hearing customers and co-workers in her work environment as a pharmacy technician. This individual, a 46-year-old African American female who resides in an urban area and is hard of hearing, had been told by VR that she was not financially eligible to receive new hearing aids from VR. DRT reviewed her financial information with her and determined that it was feasible to request an exception because, although her income was above the eligibility level, her basic living expenses significantly reduced her income and did not allow for her to purchase the needed hearing aids. Subsequently, the client experienced a decrease in her work hours shortly after DRT presented the exception request to the VR regional supervisor. DRT informed VR of the situation, noting that our client had even less funds available to meet necessary living expenses, much less to pay for hearing aids. The VR regional supervisor agreed to complete a new Financial Needs Assessment using our client’s current income rather than relying on the prior year’s adjusted gross income from the federal tax return. The outcome showed that our client was financially eligible, so our client's IPE was amended to include the provision of new hearing aids. Our client has obtained her new hearing aids and has reported that she is able to hear customers and co-workers much more clearly at work. DRT assisted an individual with an employment goal of Human Resources Manager get the education she needed. This individual, a 59-year-old African-American female with physical orthopedic disabilities living in a rural area, requested VR to help her complete her Master’s degree at the college she had attended on her own but could no longer fund on her own. Since she had been attending a private school, VR per its policy could only partially fund our client’s education since its cost exceeded state school rates. Our client agreed to attend a state school, but the state school told her they would not transfer her credits from the private school, which meant she would be starting all over on her Master’s degree. VR did not want to sponsor an entire Master’s degree, so DRT requested for VR to sponsor our client at the private college where she only had four courses left to complete her degree. DRT also requested VR to exceed state rates and sponsor our client’s degree completion without financial contribution from her. After consideration of the exception request, VR decided to sponsor our client fully to complete her degree at the private college. Our client’s IPE was amended to reflect this decision. DRT assisted an individual who wanted to secure and obtain employment but felt that VR was not helping her reach her goals. The individual, a sixty-year-old African American female with mental illness living in an urban county, wanted employment preparation training to increase her computer skills. DRT worked with our client on self-advocacy skills and strategies which enabled her to make informed choices. DRT also met with our client and her VR counselor to discuss possible options. As a result of this meeting, our client is now pursuing computer training through the American Job Center and driver training to obtain her driver’s license. She reported that she now feels VR is providing her with services which will enable her to secure and maintain employment.


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 OfficialLisa Primm
Title of Designated Agency OfficialExecutive Director
Date Signed12/11/2017