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RSA-227 for FY-2021: Submission #1191

Massachusetts
09/30/2021
General Information
Designated Agency Identification
Massachusetts Office on Disability
One Ashburton Place, #1305
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Boston
MA
02143
617-727-7440
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800-322-2020
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Operating Agency (if different from Designated Agency)
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Additional Information
Naomi Goldberg
Naomi Goldberg
617-979-7327
naomi.goldberg@mass.gov
Part I. Non-case Services
A. Information and Referral Services (I&R)
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167
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204
1703
143
2402
B. Training Activities
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2677
Throughout the year CAP performs outreach in an attempt to schedule trainings/presentations on the subject of VR/IL/CAP and Title I of the ADA. During FFY21, as many programs, services, and schools continued to work remotely and struggle with providing their basic services, CAP also struggled to find entities that were willing and interested in scheduling remote presentations. Since this had been CAP’s experience during FFY20, we were prepared to somewhat shift our focus from the typical outreach and trainings that we offer. During FFY20 CAP had committed to developing a Title I related training that could be offered remotely and targeted to VR consumers.

In early FFY21, CAP began developing our Disclosure in Employment Series, a set of interactive workshops held over Zoom with a focus on Title I of the ADA. The first workshop titled, “The Decision to Disclose,” focuses on how a person with a disability decides whether or not they should disclose their disability at different stages of the employment process. The second workshop, titled “Reasonable Accommodations in Employment” focuses on best practices for requesting a reasonable accommodation and understanding the significance of essential job functions. The third workshop, titled “Disability Discrimination in Employment” provides an understanding of discrimination in the employment context. This workshop will debut in FFY22.

The Disclosure in Employment Series aims to offer an alternative way of presenting what can be complicated material. Rather than presenting information in a standard lecture type format, the workshops offer an interactive setting in which people can learn through participation in activities. Each workshop has 8 or less participants and contains exercises that help add context to the subject matter. The small group setting facilitates discussion and results in engaging discussion among the participants. Interested individuals can register for a workshop from our website. We have also offered the workshops to the staff of a center for independent living and to a vocational rehabilitation area office. Additionally, we also partnered with the Carroll Center for the Blind (CCB) to offer the series to their new students who are VR consumers. The workshop was slightly adapted to be more accessible to an audience of people who are blind. We have offered the workshop to two different CCB classes during FFY21 and will continue to offer them on an ongoing basis to new classes in FY22.

CAP did targeted advertising of the workshop to both VR agencies in the state, to community colleges, centers for independent living, career centers and providers of job placements services, as well to attendees of events sponsored by Mass Office on Disability, among others. The events are similarly advertised on the agency’s website and in presentations that the agency has provided during the year. CAP has found that VR counselors and job placement professionals are interested in the training for themselves and continue to refer their consumers to attend. During FFY21 we offered a total 20 sessions of the workshop.

During FFY21 CAP’s attempts to connect with the public workforce system resulted in a VR/IL/CAP training with MassHire Department of Career Services.

CAP held “listening sessions” with two area VR offices from the general VR agency and one with staff at the blind VR agency. In these sessions we provide an overview of CAP, explaining the various ways that our involvement in cases earlier in the process can be helpful to VR, while simultaneously seeking guidance from the VR staff as to how we can best work together to serve consumers. CAP considers VR to be our best source of referrals and therefore is committed to consistently working at building and maintaining our relationship with them with the understanding that we have different roles and will sometimes disagree.

CAP held a listening session with a CIL that is a pre-ets provider directed to the staff that specifically works with transition youth. The focus of this presentation was on how best to navigate the system when first starting out as a VR consumer.

CAP offered a VR/IL/CAP presentation for an employment collaborative that was largely made up of agencies that assist individuals with disabilities in obtaining employment.

Finally, CAP provided a VR/IL/CAP based presentation at a virtual transition fair for a private school that serves students with severe disabilities.

During FFY21, Massachusetts Office on Disability (MOD), the agency in which CAP is housed provided four other trainings on Title I of the ADA to Title II entities (state agencies). MOD also provided a range of trainings on other topics including effective communication, architectural accessibility, technology usability, and emergency preparedness. The attendees of these trainings included state and municipal employees, people with disabilities and their family members, local disability commissions, human resource professionals, and title III entities. At each training conducted by MOD, regardless of the subject, MOD prefaces with a brief explanation of CAP and its role with respect to VR and IL and provides informational brochures (or links). The total number of trainings and attendees reflects the number for all MOD trainings.
C. Agency Outreach
CAP continued to perform outreach throughout FFY21 despite the lack of opportunity to exhibit at in person events. Most of the annual conferences and events at which we normally exhibit were canceled and the in-person outreach that we typically try to organize with schools and service providers was very challenging to schedule in consequence of the pandemic. Nevertheless, CAP continued to reach out to entities across the state that interact with unserved/underserved populations to inform them of VR/IL, CAP, and Title I. These entities included community action and community development programs, multi-service agencies serving specific minority populations, the Black and Latino Advisory Commissions in state government, school districts in unserved and underserved areas, community colleges disability related nonprofits including centers for independent living, and agencies that assist individuals with disabilities with job placement. We recognize that to make a true connection and to build trust with organizations that represent minority populations requires ongoing effort and facetime, which was difficult to implement during a time when there are fewer events taking place that offer the opportunity to make new connections.

CAP has performed strategical marketing aimed at diverse populations, asking for the opportunity to meet and share how we could be of assistance to their constituencies and offer our VR/IL/CAP presentation. We also shared a link to our video and a short article about CAP and invited these entities to post the video on their website and/or to use our article in their newsletters. We continued to follow up with these entities to attempt to schedule trainings/presentations. Separate from these efforts we separately advertised our Disclosure in Employment Series to similar entities.

Given the challenges to providing outreach during these difficult times, CAP mainly focused on addressing the needs of unserved and underserved populations through its work on the SRC of the general VR agency. CAP, along with other members of the SRC, pointed out the need for education and support around incorporating diversity, equity, and inclusion (DEI) into the SRC’s work, and advocated that the main VR agency hire a DEI consultant for the SRC. CAP participated in the RFR process and selection, and ultimately a consultant was hired, Health Management Associates in partnership with a local CIL. The consultant offered multiple sessions to provide education, strategic planning, and capacity building and ultimately provided a five-year roadmap to practice and advance DEI within the SRC's operations. CAP is confident that this roadmap adds the necessary structure to ensure that the SRC not only continues to evaluate how unserved/underserved populations are served by VR and impacted by various decisions, but that the actions that the SRC takes are aimed at making VR services equitable for consumers that have been traditionally overlooked.

During FFY21 CAP actively participated in the work of all of the committees on this SRC including Policy, Business and Employment, Statewide Comprehensive Needs Assessment/Consumer Satisfaction Committee, and Executive which either meet monthly or bimonthly. Each committee focuses on the specific recommendations made by members of the public to improve VR services and practices. In FFY21 each committee re-evaluated the existing recommendations that were assigned to them to ensure that the needs of unserved and underserved populations are always considered in efforts to improve VR service. This additional focus highlighted the need for more data about how communities of color are faring in particular areas of VR. With that in mind, the Statewide Comprehensive Needs Assessment/Consumer Satisfaction Committee determined that survey questions needed to be changed and that there needed to be consideration as to how to best ensure that all consumers are surveyed whether or not they have access to technology. The committee began the process of engaging with a consultant to help revamp the annual needs assessment survey to gain a better understanding of the gaps that consumers from unserved/underserved populations experience with the agency. Meanwhile, the Policy Committee continues to focus on ensuring that vendors who serve VR consumers can meet the cultural and linguistic needs of unserved and underserved populations. During FFY21 the committee continued to explore the complicated procurement system and to identify barriers to imposing particular requirements on vendors that would increase their capacity to serve diverse populations. The committee aims to offering final recommendations to VR about how to improve in this area during FFY22.
D. Information Disseminated To The Public By Your Agency
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E. Information Disseminated About Your Agency By External Media Coverage
CAP contributed a dedicated chapter about vocational rehabilitation to a publication titled, "Legal Rights of Individuals with Disabilities." The publication, which was in its third edition, was being reissued by the Protection and Advocacy agency and various legal aid agencies in Massachusetts. The authors requested that CAP revise a previously written chapter on vocational rehabilitation that predated WIOA and required substantial editing and revision. The final product titled, "Vocational Rehabilitation Services and other Work-Related Issues," provided a detailed description of the basic elements of vocational rehabilitation services.

The publication's target audience is disability advocates and attorneys who are typically unsure of how to navigate VR. CAP is hopeful that this will increase our exposure and that other agencies will continue to reach out to CAP for assistance and connect us with consumers and other agencies who work with consumers who need assistance.
Part II. Individual Case Services
A. Individuals served
14
27
41
0
7
B. Problem areas
14
18
21
1
0
24
0
1
C. Intervention Strategies for closed cases
16
10
3
0
3
2
34
D. Reasons for closing individuals' case files
14
5
7
0
1
4
2
0
1
0
0
0
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E. Results achieved for individuals
14
1
1
1
9
1
1
6
0
0
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Part III. Program Data
A. Age
0
5
15
18
3
41
B. Gender
22
19
41
C. Race/ethnicity of Individuals Served
1
0
4
6
1
29
0
0
D. Primary disabling condition of individuals served
3
1
0
0
1
2
5
0
2
0
0
0
2
1
0
0
0
0
1
0
11
0
0
4
2
0
1
0
0
3
0
0
2
0
41
E. Types of Individuals Served
2
0
38
0
0
1
Part IV. Systemic Activities and Litigation
A. Non-Litigation Systemic Activities
2
In FFY21 CAP addressed several issues that appeared to be systemic in nature.

While it is understood that administrative review (AR) officers are internal VR staff and are often acquainted with staff representing the agency at the AR, CAP has observed that officers sometimes appear biased. Previously, CAP has relayed instances of consumers finding the officers speaking privately with the VR staff as they arrive to the AR or after it is over, or make statements that appear to support the agency’s position before they even speak to the consumer. CAP has mentioned these experiences to VR and while it has been acknowledged that such behavior is not appropriate, it did not appear that any formal action was taken in response to these shared observations. During FFY21, CAP had formally committed to assist a particular consumer with an AR and was working with them on preparing the argument. Meanwhile, the AR officer contacted the consumer and said that they wanted to discuss the case. The consumer informed them that they wanted to include the CAP Advocate in any discussion and the AR officer responded that it was not necessary for CAP to join the conversation because they were just asking questions and wanted to discuss the case. They ultimately pressured the consumer to speak anyway and over the course of the conversation informed the consumer that VR never pays for graduate school. In response, CAP contacted the General Counsel to express serious concerns about the pre-AR separate conversation, the disregard of the consumer’s request to have CAP present, the completely inaccurate statement that was made about VR not supporting graduate school, and the fact that the person making the decision was biased. The VR agency acknowledged the concerns and agreed to send out notice to all AR officers clarifying their responsibilities and CAP’s role. Additionally, a new AR officer was assigned to the case.

CAP had noticed during FFY20 that financial participation documents listed outdated figures representing poverty levels from previous years. After CAP pointed it out and then followed up, the VR agency to request that they fix it. When it did not appear to be fixed and CAP continued to notice it when assisting consumers, CAP reached out again. VR informed CAP that a workgroup had been formed to update the financial need determination policy and annual dollar limits, and that they could not simply change the forms without first updating their policy and their data system. They insisted they were working on it and the change occurred during FFY21. VR recognized that they will need to continually update the figures and assigned this duty to a particular position. Additionally they implemented an alert in their system to ensure that the figures are updated on an annual basis as the poverty levels change.

In recent years CAP had noticed that college bound VR consumers were often unaware of important college related resources. In consequence, CAP initiated a recommendation to the SRC that the main VR agency hire or assign a dedicated VR counselor that has expertise in college related issue and resources s to work with college bound consumers. This recommendation was assigned to the SRC Policy Committee. When VR responded to the recommendation that it would not be possible to have dedicated counselors for this population of consumers, the Policy Committee and CAP pivoted and created a packet of information that all VR counselors could use with their college bound consumers. CAP and the committee began working on the packet in FFY20 and completed it in FFY21. The foundation document in the packet is a checklist of important contact information and dates for students (e.g. VR counselor, disability services office, advisors, important dates, financial aid office, community supports, add/drop dates, etc.) that can be filled in independently or with the assistance of a VR counselor. Also included in the packet are financial aid and similar resources, a form letter that can be used to inform the consumer of important VR procedures and instructions, a faq on disability rights in higher education, a fact sheet on reasonable accommodations in academic settings, and information about online learning strategies. CAP and the Policy Committee maintain that providing the same comprehensive set of information to each VR consumer attending college further enhances VR’s commitment to ensuring that all consumers have an equal opportunity to engage in VR services. CAP and the Policy Committee requested that VR incorporate the curriculum into their practice. VR expressed interest in the material and committed to reviewing it with area office managers to determine if/how they can use the material for consumers in FY22.
B. Litigation
0
0
0
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Part V. Agency Information
A. Designated Agency
External-other public agency
Massachusetts Office on Disability
No
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B. Staff Employed
CAP employed three full time employees in FFY2021.
Part VI. Case Examples
Case Examples
Case #1
CAP had successfully represented a VR consumer in a fair hearing during FFY20. The consumer has a learning disability and wanted to pursue a degree to become a Physician’s Assistant (PA). VR initially told her that they do not provide assistance for graduate school but subsequently said they would provide her with the maximum amount that they pay for school and books which was $3200 and $1200 respectively. Since the tuition was roughly $40k per year, the consumer requested a waiver. She contacted CAP when the waiver was denied. CAP ultimately took the case to fair hearing and was successful. Specifically, the decision granted her a waiver of the maximum obligation policy and determined that VR was responsible for providing the financial support she needed to obtain her graduate degree. The CAP case was successfully closed during FFY20. The consumer contacted CAP during FFY21 when there was a disagreement about the support to be provided for transportation and maintenance.

The PA program the consumer attends requires successful completion of six clinical rotations. Although the educational program is located in Massachusetts, the rotations take place at medical facilities located throughout the Northeast region of the country. Students in the program are assigned to the various rotation sites and do not have control over the locations at which they are placed. For that reason, the consumer requested that VR assist with costs in excess of her normal living expenses, including lodging and transportation. The consumer does not have a car and although she would use public transportation as much as possible to get to the locations and to travel between her lodging and the placement sites, she would need to have access to a vehicle for most placements. Therefore, she requested funding for rental cars. The VR agency denied her request for assistance with rental cars, parking expenses, and full lodging costs. Alternatively, they offered to provide her with a vehicle through the Good News Garage (GNG), a program that provides used cars to people who have low income. They also proposed that she could lay out the money for any out-of-pocket costs and submit receipts for reimbursement afterwards.

The consumer rejected the offer to accept a donated vehicle and had several reasons for doing so. First, she doesn’t want to own a vehicle. She does not have a Massachusetts driver’s license, she lives in the city and has no access to a parking space, she cannot afford any upfront or maintenance costs for a vehicle, and she only needs access to a vehicle for a short time and for the specific purpose of participating in these six clinical rotations. Additionally, as the consumer and the VR agency disagreed over expenses, her rotations were already beginning. This meant she was going to be forced to put the expenses on her credit card when she does not have the resources to do so. Further, even if she were willing to accept the donated vehicle, it was essentially the last minute and there wasn’t sufficient time to work out the logistics of making it available for her use . There was also disagreement between the consumer and the VR agency about the lodging that would be funded. The consumer maintained that she required lodging that had wifi access and her own bathroom. This meant in some instances that she could not opt for the least expensive lodging option, which was what the VR agency required. She also maintained that she would need assistance with parking in instances in which free parking was not available and the VR agency disagreed. The consumer subsequently requested the help of the CAP to appeal the decision to deny the reasonable costs of rental cars, parking, and expenses related to lodging.

CAP initially attempted to resolve this issue informally pointing out that the expenses in question should be covered per the fair hearing decision and the federal regulations. Additionally, CAP pointed out that the VR’s proposal would delay the progress of the consumer toward achieving the employment outcome identified in their IPE. After reaching an impasse with the agency, the consumer filed an appeal for a fair hearing with CAP’s assistance. CAP went through the process of gathering evidence, researching the regulations, and writing a legal memo with exhibits. The hearing was scheduled for the beginning of FY22. CAP intends to reach out to the legal department again to relay the argument it will make at fair hearing with the hope that there is still room to resolve the matter.

Case #2
In FY21, CAP was involved in a consumer’s case that required extensive negotiations around the development and implementation of an Individualized Plan for Employment (IPE) with a customized employment outcome.

The consumer has Autism Spectrum Disorder and entered VR through the transition program at his high school. At that time, he also qualified for and received services from the Department of Developmental Services (DDS). The consumer entered college with the help of VR and obtained an Associate’s Degree in Criminal Justice. He also earned a Certificate for the MS Office Suite. When the consumer began to search for jobs, VR encouraged him to get assistance from DDS because DDS could offer more support with employment. VR explained that the consumer likely would need the support of a job coach long-term and said they would only be able to offer that on a short term basis while DDS could offer it on an ongoing basis. The consumer’s parents reviewed the DDS employment services and considered them unsatisfactory as they believed that the agency seems to steer consumers toward group employment. For that reason, the consumer and his mother began discussing customized employment with VR. When they reached an impasse in the discussion, VR directed them to CAP for assistance.

The case highlighted three systemic issues with which CAP has been and is working to resolve. First, VR consumers who have cognitive or developmental disabilities are often sent to the DDS even if they are high functioning. Second, VR made every effort to avoid writing a customized employment IPE, likely due to the time commitment it involves. Third, as CAP monitored the implementation of this customized IPE, CAP discovered that the VR agency does not contract with enough vendors who can provide services to individuals choosing customize employment.

CAP helped the consumer understand the federal vocational rehabilitation regulations around customized employment and informed choice. Using these tenets from the regulations, CAP and the consumer were able to negotiate a customized employment IPE where the consumer has an employment outcome of an Office Assistant position that makes use of his computer skills and with a preference for a legal environment. This IPE was also unique because it set forth the level of involvement for his parents, outlined his effective communication needs, and included notes from his medical provider that can assist VR with determining whether a work environment meets his needs. VR was very reluctant to have the IPE so detailed, but under the regulations, this was exactly the type of information that an IPE should contain.

As VR started to implement the IPE, CAP stayed involved to monitor progress. The VR agency often uses Competitive Integrated employment Services (CIES) vendors when VR consumers require extensive support. Previously, the consumer and his mom had a very negative experience with one of the CIES vendors. Therefore, they requested CAP assistance with researching and filtering out proposed vendors. During this review, CAP discovered that VR did not have sufficient vendors who were available to implement a customized employment IPE. Currently, the consumer and his mom are planning to meet with VR to discuss the lack of sufficient vendors that can meet his needs. CAP has agreed to attend the meeting at the consumer’s request. In these meetings, CAP’s role has been to clarify regulatory requirements around customized employment, informed choice, and effective communication. CAP has also been able to moderate discussions between the consumer and VR to ensure that both parties understand their obligations under the regulations. Finally, we often propose solutions to ensure that VR services are rendered for the benefit of the consumer.

Case #3
A VR consumer contacted CAP to report that the VR agency had denied his request to support him in his MFA program by providing tutors. The consumer is a working artist who has Autism Spectrum Disorder (ASD) and learning disabilities. The consumer reported that he initially asked VR to fund tuition and books for his program, and they declined stating that VR does not fund graduate school. The consumer accepted that explanation and enrolled in the MFA program anyway. Due to his learning disabilities, he was having a lot of difficulty completing writing assignments. Consequently, he began utilizing the tutoring support that is available at the school although it was not sufficient to meet his needs. For that reason, he would like VR to supplement the tutoring services that he already received through the school. The consumer explained that obtaining an MFA degree will increase his chances of getting art related grants. He also maintained that due to having ASD, he is not able to network as well as artists that don’t have ASD, and the exposure to the school and other artists would increase his visibility and help sell his artwork. The consumer was unable to relay what his specific goal was with VR, he did not what an IPE was, and he seemed altogether unclear of how VR works.
Upon reviewing the file and speaking to the counselor, CAP learned that the consumer had a self-employment goal to be a working artist, and that VR had provided various supports over time to get his business started, including providing tools and a website. Further, it was their position that he was operating a successful business and that he was all set with VR services. When CAP went back to the consumer to relay that his goal appeared to be self-employment, that VR seemed to believe that he reached his goal already, and that this appeared to be the reason that they would not support him with graduate school, he said that this was never explained to him. He reiterated that when he asked for funding for school, the counselor did not offer this explanation but instead said that they do not pay for graduate school at all and asked him if he needed any other tools for his business. The consumer then told the counselor that he could use a particular tool and they subsequently purchased it for him. He then continued to pursue his degree while his case remained open.

Although CAP understood why VR did not agree to support graduate school when he asked, we saw a problem with their overall communication. It appeared that VR thought that the consumer had achieved his goal quite some time before and did not communicate that to him. His case remained open and when he later requested financial assistance with graduate school, instead of explaining to him that going back to school was not part of his plan, that he could appeal, and what he could do if he wanted to amend his IPE, they offered to pay for something else. Meanwhile, the consumer continued to go to school but was struggling with coursework that was writing related.

Upon hearing from CAP that in general it is possible for VR to pay for graduate school, the consumer was upset and said he wanted to appeal the denial. Shortly thereafter, upon speaking to CAP about the merits of the case, he decided that he only wanted to pursue his request for tutoring and requested an administrative review. CAP tried to informally settle the issue by asking whether VR would be willing to provide some tutoring in the subject of writing, given all of the miscommunication and since the consumer was already in the program and it would increase his chances of success. VR’s position was that they never agreed to a plan for graduate school and therefore would not fund tutoring for graduate school. They maintained that they would offer tutoring if it was related to his self-employment goal, but the consumer obviously could not say that he needed a tutor to help build his business when he clearly needed one to help with a course. CAP ultimately agreed to represent him at the administrative review at which time the case was settled. Specifically, it was agreed that the case would go into post-employment, he would receive a tech evaluation and then corresponding services would be provided that would assist him with his writing. The consumer reported that he was satisfied with the outcome.
Certification
Approved
Naomi B Goldberg
CAP Director
2021-12-22
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