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RSA-227 for FY-2021: Submission #1193

Texas
09/30/2021
General Information
Designated Agency Identification
Disability Rights Texas
2222 W. Braker Lane
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Austin
Texas
78758
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Operating Agency (if different from Designated Agency)
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Additional Information
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Part I. Non-case Services
A. Information and Referral Services (I&R)
45
2
0
0
4
50
101
B. Training Activities
78
4254
(a) CAP conducted outreach to various organizations and groups with the intent to inform people about DRTx and the many programs and services the agency can provide. CAP also provides the public with information about the CAP program and services, Vocational Rehabilitation services and Independent Living Services, including older individuals who are blind. CAP has also developed presentations for Pre-employment transition students to teach them about Pre ETS services, transition services, self-advocacy, competitive integrated employment, disability rights, and information on services provided through these programs.

(b) The purpose of our training was to educate the public about the Vocational Rehabilitation Program, the Independent Living Centers and Programs, and the Client Assistance Program. We also want to make people aware of the types of services provided, their rights when receiving these services, and who to contact if they encounter problems, questions or difficulties in the receipt of these services.

(c) Attendees included TWS-VRS staff and consumers, independent living staff and consumers, organizations that serve the homeless, resource meetings for multiple organizations with the purpose and intent to share information and knowledge; disability organizations professional staff and consumers including the Epilepsy Foundation, the Autism Society of Texas, mental health organizations and Deaf and Hard of Hearing Centers. Attendees also included parents, transition-age students with disabilities, and Parent Resource Groups and organizations that served primarily Spanish Speaking individuals.
C. Agency Outreach
CAP staff were part of an internal committee formed for the expressed purpose of identifying unserved and underserved individuals and groups. Data was analyzed including disabilities, age groups, geographical areas, language, and racial, ethnic and other cultural identities. We identified areas we needed to reach out to including transition-age students, deaf/hard of hearing persons, individuals who are Autistic, individuals who are Blind or visually impaired, and individuals whose preferred language is Spanish Speaking and Native Americans.

The committee began researching organizations that may serve these individuals and contacted them for outreach purposes. We were successful in reaching many of these organizations and CAP case numbers increased in all of the previously mentioned groups with the exception of Native Americans. We were able to identify Five Tribes in Texas. The Tribes in Texas do not have a grant to provide their own Vocational Rehabilitation (VR) services. Therefore, Native Americans in Texas are to be served by the TWS-VRS agency. Attempts to contact the Tribes were made, but we were not successful in receiving a response. The committee did more research and determined that training on working with Native Americans may need to occur prior to being successful in reaching out to this group. We are identifying ways to obtain this training at the current time.

DRTx and CAP are working on a project whose goal is also to reach unserved and underserved areas of the state. We have worked in conjunction with those staff who are reaching out to rural communities to inform individuals of the CAP and VR/IL programs. Additionally, CAP has participated in legal clinics set up by the organization that provide information about VR/CAP/Accommodations and their rights in a post-secondary school setting. CAP has coordinated with TWS-VR informing their staff of this free training that includes consulting with an attorney. CAP participated in five virtual clinics this year. Some clinics were designated for persons who speak primarily Spanish and those who utilize ASL for communication.
D. Information Disseminated To The Public By Your Agency
75
3
3
27748
51
0
N/A
E. Information Disseminated About Your Agency By External Media Coverage
Jeanie Hanzal, a CAP Advocate who worked on a self-employment case with TWS-VRS, thought it would be beneficial to get the word out about the collaboration of Texas AgrAbility and Vocational Rehabilitation Services/CAP. Ms. Hanzal coordinated the webinar with the Texas Rehabilitation Association Lunch and Learn Series. The announcement of the event is captured in the following link: https://www.feedlotmagazine.com/news/three-webinars-scheduled-for-disabled-individuals-in-agriculture/article_2000219c-ff8f-11eb-ac4c-b74cf6718801.html; a Webinar for Disabled Individuals in Agriculture in Feed Lot Magazine.

Additional media coverage was obtained during the year through the following sources;
Sources include but not limited to: New York Times; CBS Evening News; Associated Press; Local TV and newspaper in major markets: Houston, San Antonio, Austin, Dallas; Texas Tribune; Texas Standard/Texas Public Radio; Local TV and newspapers in smaller markets: Bryan, Waco, Lubbock, Corpus Christi, Amarillo, Laredo, El Paso, San Angelo. Gilmer, Temple, Pflugerville, Cleburne; Telemundo in Midland/Odessa, Univision in Dallas.

The social media coverage for year 2021 resulted in 1,217 placements, a reach of 3.1 billion viewers and an advertising value of $28.7 million.
Part II. Individual Case Services
A. Individuals served
116
194
310
18
153
B. Problem areas
23
55
115
75
0
50
10
0
C. Intervention Strategies for closed cases
17
56
102
1
1
2
179
D. Reasons for closing individuals' case files
118
11
5
3
1
24
0
3
13
0
1
0
N/A
E. Results achieved for individuals
35
15
6
0
77
24
16
6
0
0
N/A
Part III. Program Data
A. Age
13
56
94
136
11
310
B. Gender
131
179
310
C. Race/ethnicity of Individuals Served
72
2
10
84
1
125
14
2
D. Primary disabling condition of individuals served
12
14
0
8
3
6
45
2
21
9
2
10
16
10
3
4
2
2
3
16
62
3
2
5
14
15
1
1
0
12
0
4
2
1
310
E. Types of Individuals Served
122
0
165
14
11
0
Part IV. Systemic Activities and Litigation
A. Non-Litigation Systemic Activities
9
CAP staff addressed systemic issues both at a regional and state office level during the year. Those efforts included the following:
a. Comparable Benefits: TWS-VR policy said that comparable benefits had to be explored prior to a vehicle modification. CAP shared the section of the regulations regarding comparable benefits that specifically states rehab technology is not included in the comparable benefits requirement. The policy was updated and the requirement to search for comparable benefits for a vehicle modification was removed.
b. Eligibility Factors: The TWS-VR policy manual provides legal reference followed by policy in each chapter. The policy on eligibility legal reference section noted the areas in the regulations that state prohibited factors to consider when determining eligibility. However, the policy section of the same chapter did not list the prohibited factors when determining eligibility such as education level, employment status, type of employment outcome, etc. CAP asked that the factors be listed in the policy section of the manual and VR agreed. They have since been included in the policy section of the manual.
c. Best Practice in wording policy: TWS-VR has been submitting proposed policies for both CAP and the State Rehab Council utilizing the word “must” in nearly every policy. This type of wording gives in impression there are no exceptions. CAP provided TWS-VR with recommendations on how wording in the policy manual prior to TWC implementing the VR program included words such as “shall” and “may” when exceptions were allowed. The use of the word “must” was reserved for policy where there were no exceptions. CAP also noted that TWC administers other programs and those programs also reserved the use of the word “must” for policies where exceptions were not allowed referencing the law. After providing TWS-VR with the other TWC programs policies stating the use of the word “must” was reserved for policies referencing the law and exceptions could not be granted, and more discussion, TWS-VRS agreed to stop using “must” for every policy.
d. Financial Needs/Financial Participation: The Texas VR program performs a financial needs test. Those who showed they were below the financial needs test, or did not have funds to participate in the cost of services, were not required to participate in the cost of services. When TWC began administering the VR program they interpreted this aspect of the program differently. The financial needs test became a process of determining how much a person would need to participate in the cost of services. There was no expectation if a person fell below the table’s financial resources, that they would not have to participate in the cost of services. As a result, everyone was expected to participate in the cost of services if there was a rate limit of what VR could pay for a service such as tuition. CAP has been in discussion with TWS-VRS for over two years discussing this difference. CAP has enlisted NDRN, and RSA in the conversation. This past year, TWS-VRS agreed to put in policy in place stating that people below the financial needs (in the policy manual it is referred to as the Basic Living Requirement, or BLR) would not be required to participate in the cost of services. They have specified that rates do apply, but exceptions can be made.
e. Informed Choice: In exercising informed choice, CAP noticed that job placement providers were not returning phone calls to clients or CAP, when attempts to get information to learn how they provided placement services were made. We found providers either did not return calls or would state that a service authorization needed to be issued by TWS-VR before they would talk to us. CAP brought this to the attention of the TWS-VR management at State Office. The University of North Texas, UNT, has a contract to provide training for all job placement providers (and Supported employment providers) prior to being able to service TWS-VR clients. There is no training to providers on Informed Choice and there is no information in the Standards for Providers on this subject. CAP/VR and UNT worked together to put together training for providers on the importance of communicating with clients about their program and making providers aware of the importance in the VR program of informed choice. The training module was completed and available to providers for free.
f. CAP requested and reviewed the TWS-VRS Pre Employment Transition Services (Pre-ETS) forms provided to Pre ETS-clients. Information about the CAP program was not mentioned in any of the paperwork. Therefore, CAP asked TWS-VR to include on the Pre ETS-paperwork information about the CAP program. TWS-VRS agreed to revise and include information about CAP.
g. Timeliness of services has been an area of focus discussed in the quarterly meetings CAP conducts with TWS-VRS. TWS-VRS has implemented various controls, reviews, consultations, and approvals that have delayed services and, in some instances, significantly so. Timeframes from beginning to end in various CAP cases were shared with the state office. TWS-VRS responded in a number of ways. First, TWS-VRS set up a committee to look specifically at one service that had been significantly delayed - vehicle modifications. The committee made recommendations and changes to policy in an effort to improve the timeliness of the service and make it less cumbersome. CAP and the RCT had the opportunity to review and comment on the changes made to the policy. Second, TWS-VRS also established a committee to review management approvals on services and consultations. Recommendations were made to remove 66 of those approval steps to make services more timely with less oversight. CAP/RCT reviewed the recommendations and made comments. Additional recommendations were made and the committee will be reviewing them.
h. The CAP team met with the TWS-VRS State office Management Team on a monthly basis throughout the year. The purpose of these meetings was to share with TWS-VRS what was working and not working from perspective of the CAP team in regards to the new changes made when providing services to clients. This included the ease or difficulty in reaching TWS-VRS staff in co-located offices with the Texas Workforce Solutions offices. Both clients and CAP had major problems reaching TWS-VRS staff. The additional purpose of this meeting was to learn about the changes TWS-VRS were making to provide VR services during COVID, including remote service delivery, signing of IPE’s via TEAMS, ability to meet with clients in person or virtually, progress in moving to an electronic system within VR, delays in receiving equipment and other ways to improve the process. This collaboration has been invaluable for both parties and has helped improve the process and delivery of services and communication with CAP/TWS-VRS and clients.
i. CAP has a seat on the Rehabilitation Council of Texas (RCT) and CAP serves on the Policy, Procedure and Personnel committee. CAP reviews all proposed policies and provides comment trough the RCT. CAP also brings issues of concern to the council and collaborates to address systemic issues. Mutual goals include reviewing, discussing, and making recommendations on the approval processes at TWS-VRS, as well as discussion and recommendations on employee morale at TWS-VRS. CAP and the RCT participated in the Quarterly Provider calls since the fiscal year. Providers are invited to attend a call on a quarterly basis with the RCT/SRC and TWS-VRS with a prepared agenda to discuss. One of the items on the agenda this past year was the Informed Choice training CAP worked on with TWS-VR and UNT. CAP listens to the concerns of the providers in comparison with the concerns voiced from the clients including how policy and guidance are relayed to providers and services are being delivered. Additionally, feedback from CAP, the RCT, and providers to TWS-VRS regarding the delay in obtaining contract exceptions during COVID from the agency was so significant, that CAP/RCT asked TWS-VRS to identify what state rule or contract stated only the VR Director could make a contract exception. They confirmed that this rule was not actually in writing, it was just the practice they were following. After that discovery and putting some of the COVID exceptions into policy, this practice was reduced.
B. Litigation
0
0
0
There has not been any ongoing systemic litigation activities involving individual representation in the last year.
Part V. Agency Information
A. Designated Agency
External-Protection and Advocacy agency
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No
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B. Staff Employed
Position FTE % of year person-years;
Professional full time: 11.39 FTE
Professional part-time: 0 FTE
Professional vacant: 0 FTE

Clerical full time: 0.72 FTE
Clerical part-time: 0 FTE
Clerical vacant: 0 FTE
Part VI. Case Examples
Case Examples
Case 1: Client, male, 36 years old with ADHD, scoliosis with bulging discs, and plantar fasciitis, was denied assistance with a modification that would raise and lower his computer on a desk, a standing desk monitor rise, allowing him to change positions every 30 minutes to accommodate his back and feet issues while he searched for employment. The client could not apply for jobs as he experienced pain, and his pain was increasing because he didn’t have this device to accommodate his needs. He was seeking an office job and would need the same equipment for employment. The TWS-VRS counselor denied the request stating that the client was not employed and the service could only be provided for an employment. CAP investigated his case and found out that his TWS-VRS counselor had medical information informing her of his back issues, but she claimed she did not have records to support his request. In addition, she had not taken any action to communicate with the doctor regarding the client’s request. CAP asked the TWS-VRS counselor to communicate with his doctor to obtain additional information needed to proceed in considering the request. A Functional Capacity Assessment (FCA) was conducted as well as an assistive technology evaluation with recommendations for a desk, the desk monitor riser, as well as a cushioned floor mat. TWS-VRS agreed to pay for the desk and additional recommended accommodations. TWS-VRS also provided special shoes to address the issues he had with Plantar Fasciitis. Communication between the client and the TWS-VRS counselor improved. All the client’s issues were resolved.

Case 2: Client, male, age 55 who is a recipient of Social Security (SS), with disabilities of mental illness, ADHD, chronic pain syndrome, and arthritis, contacted CAP a year after TWS-VRS closed his case without reaching an agreement for a plan for self-employment. CAP investigated his complaint and it appeared TWS-VRS had supported the client in college to become a photographer but they could not agree on what equipment was needed and where he would live to begin his employment. TWS-VR would not approve the plan he submitted. His case had been closed, but TWS-VR continued communication with the client if he were to provide an updated business plan. CAP requested a new application for services, and attempts were made to work with the same office/counselor but this proved to be problematic. A request was made to move to the case to a new office and management. This was approved. A different counselor began working with the client and he was referred to work with a Certified Business Technical Assistance Consultant (CBTAC) to help him write his business plan. Client is receiving support, advice, assistance and help writing his business plan and his TWS-VRS counselor is working closely with him to help him submit a complete self-employment plan the agency can review.

Case 3: Client, female, in her 20’swith a disability of cerebral palsy, utilizes a power wheelchair, contacted CAP after she was informed the modifications on her vehicle would not pass state inspection. Before a vehicle can be released to a client, it has to pass national safety standards for vehicle modifications. Based on the weight of her vehicle, it would not pass the inspection. CAP investigated her case and the problem. CAP requested communication and collaboration with TWS-VRS, the vehicle modification provider, the vehicle lift provider, and the Texas A&M Transportation Institute, (TTI) inspectors to work together to see what, if any, solutions could be adapted on the vehicle. After exhausting all other possibilities, the end result was for TWS-VRS to remove the modifications to her vehicle that would have allowed her to drive. The client purchased a vehicle that was recommended and agreed upon by all parties as to what would accommodate the equipment she would need. The modifications were made to her new vehicle and the client is now driving safely in her modified van.

Case 4: Client, male, in his 40’s who is a Social Security recipient with a disability of Autism had attempted education in college and needed further counseling and guidance on his vocational goal and how to achieve the goal. He had a counselor who was not willing to provide this guidance. Client contacted CAP. Client had just finished a semester of college when he contacted CAP, and in investigating his case, CAP discovered the client had paid for the previous semester of college instead of TWS-VRS. The service was listed on his Individualized Plan for Employment, (IPE) and he had provided the TWS-VRS counselor the information in advance so VR could have issued the service authorization prior to the semester starting. The client had reported to the TWS-VRS counselor that he had put the semester tuition (a month early) on a credit card to hold his registration at the college so his classes would not be dropped. The TWS-VRS counselor interpreted that to mean he had paid his tuition and she could not reimburse him. CAP brought this issue with up the counselor, supervisor, and manager and the Regional office that the service should have been paid by TWS-VRS because it was listed on the IPE as a service TWS-VRS would provide, and he was a Social Security recipient and should not be required to participate in the cost of services. The agency had plenty of time to issue the service authorization and the client would have been reimbursed by the school, not TWS-VRS. All levels in the informal process did not agree to go back and issue the service authorization to the school. CAP filed an appeal. The Legal department looked at the appeal, and agreed to pay for the semester in question. The Service Authorization was issued and the client’s account credited. Additionally, CAP requested a change in counselor and a successful relationship was established with a new TWS-VRS counselor who was willing to provide counseling and guidance to the client to explore vocational goals and a direction better suited for him.

Case 5: Client, female, in her 60’s, with orthopedic problems, chronic pain and Migraines, contacted CAP because she had applied for services requesting help with payment and resources to help pay some of her utility bills at her local Independent Living Center. Initially they told her funds were available. She did not hear back from them for over a month so she called again. She was told at that time funds were no longer available. She called CAP. CAP investigated the issue and discovered that through support from the CARES Act the ILC could assist the client, and the ILC was not out of funds. It appeared the process at the ILC was to provide this assistance twice a month. CAP encouraged communication with the ILC and the client to clarify the needs the client had, and the ILC stepped up to develop an Independent Living Plan (ILP) with the client to provide the supports she needed timely. The client’s issues were resolved.
Certification
Approved
Mary Faithfull
Executive Director
2021-12-06
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