RSA-227 for FY-2017: Submission #955

North Carolina
9/30/2017
General Information
Designated Agency Identification
Department of Health and Human Services
2801 Mail Service Center
{Empty}
Raleigh
NC
27699
http://nc.dhhs.gov/dvrs/
{Empty}
{Empty}
Operating Agency (if different from Designated Agency)
Department of Health and Human Services
2801 Mail Service Center
{Empty}
Raleigh
27699
{Empty}
{Empty}
http://nc.dhhs.gov/dvrs/
{Empty}
{Empty}
Additional Information
John Marens
John Marens
(919) 855-3600
{Empty}
Part I. Non-case Services
A. Information and Referral Services (I&R)
430
115
0
9
493
459
1506
B. Training Activities
12
656
(a)Topics of the training consisted of overviews of CAP and Rehabilitation Agency services, Empathy and Compassion, and WIOA regulations (b)the purpose of the training was to provide education on how to access services, the types of services that may be available, to assist agency personnel to be mindful of maintaining empathy and compassion for their customers, and to introduce new staff of the protection and advocacy programs and of the new regulations regarding WIOA (c)Trainings were provided to State Rehabilitation Council members, Juvenile Justice Social Workers, Rehabilitation agency staff, parents, physicians, teachers, Centers for Independent Living staff and citizens attending rehabilitation agency public forums <p><p>
C. Agency Outreach
NCCAP engages in a number of outreach efforts. Our efforts are intended to reach professionals that deal with underserved/unserved populations and to the public. CAP staff consistently exhibit at conferences where those who serve individuals who are identified as potentially underserved/unserved can be educated about both CAP and the VR agencies services. This year this includes: the Addiction Professionals of NC Annual Conference, National Association for the Mentally Ill (NAMI) Conference, the Annual National Association of Social Workers (NASW) Conference, North Carolina Conference on Visual Impairment and Blindness (NCCVIB), North Carolina Rehabilitation Association (NCRA), and the Area Health Education Centers for various conferences that focus on substance use. <p><p>CAP has also been attending the North Carolina Developmental Disability Council (NCDD) quarterly meetings where both professionals and consumers attend. CAP regularly exhibits at the NC Vocational Evaluators, Work Adjustment Specialists Annual Conference. This is of interest as many graduate students in rehabilitation counseling usually attend. All these conferences are held in different parts of the State so that CAP reaches across the geography of the State in its efforts. CAP participates in both the General VR and the DSB Public Forums across the State to reach consumers, including those in rural areas. To reach the transition population, NCCAP exhibits at the NC Annual Exceptional Children's Conference which parents and teachers attend, the NC Works Conference and the NC Division on Career Development and Transition Conference, the North Carolina Council of Administrators of Special Education (NC CASE), North Carolina Association of Higher Education Facilities Officers (NCAPPA) as well as local Transition Conferences when invited. The CAP Director participates in the quarterly Statewide Independent Living Council meetings staffed by persons with disabilities and the Directors of the Centers for Independent Living to educate members on CAP activities and services. <p><p>
D. Information Disseminated To The Public By Your Agency
0
1
0
14000
20
0
<P><p>
E. Information Disseminated About Your Agency By External Media Coverage
N/A <p><p>
Part II. Individual Case Services
A. Individuals served
21
80
101
0
23
B. Problem areas
0
10
38
4
0
9
17
0
C. Intervention Strategies for closed cases
12
31
35
0
0
0
78
D. Reasons for closing individuals' case files
55
10
8
0
0
2
2
0
1
0
0
0
<P><p>
E. Results achieved for individuals
12
0
4
1
44
6
6
5
0
0
<P><p>
Part III. Program Data
A. Age
8
13
21
48
11
101
B. Gender
61
40
101
C. Race/ethnicity of Individuals Served
0
3
0
39
0
57
1
1
D. Primary disabling condition of individuals served
5
1
0
1
7
1
1
1
3
4
0
4
0
7
0
3
0
0
0
6
16
2
2
3
3
14
1
2
0
3
0
1
2
8
101
E. Types of Individuals Served
7
0
63
23
8
0
Part IV. Systemic Activities and Litigation
A. Non-Litigation Systemic Activities
3
Follow up from last FY: 1.Last FY, the CAP focused attention on client reimbursement delays related to IPE listed services. These delays caused significant stress and hardship for clients as they often were related to rent / room & board or tuition payments. The CAP participated in a meeting with VR administrators and the State Controller&rsquo;s office and a new payment system was introduced as a result. We are happy to say that this system continues to work well and delayed reimbursement cases are now only occasional, related more to VR staff error vs. a systemic problem. <p><p>2.We also identified the length of time it took in a number of cases for van modification services to be provided. In some case, it took over a year. This remains an issue, but to a lesser extent. It still can take several months for a van modification to be completed, but these are usually related to more extensive, significant modifications, sometimes involving electronic devices. Other, less extensive modifications tend to move reasonably quickly. The CAP has established a positive relationship with the VR Chief Engineer in Raleigh and we are able to bring cases involving delays to his attention, often with a positive result. <p><p>New Systemic Issues identified: 2016 2017. <p><p>1.The CAP received some calls this past year related to denial of walk in tubs as a home modification service to clients. In all these cases, CAP was able to identify a valid medical reason for this kind of tub, but VR/IL policy clearly stated that this was a service VR/IL would not provide. Citing federal regulations that the VR agency could not categorically deny a specific service, we were able to identify that the origin of this policy was many years old, and related to the poor quality and unreliability of these tubs at the time. The CAP was able to successfully argue that VR/IL could not pick a service that it would categorically not provide, and should, at the very least, consider this service on a case by case basis. The CAP successfully argued to omit the old policy. This rewrite is currently in process, as WIOA regulations and policy updates have taken precedence in the VR agency. 2.The VR agencies have experienced significant turnover over the past few years, which has also been impacted by more retirements as the VR staff population ages. This past year, we have received numerous calls from consumers, stating that no returns their phone calls, and they were unaware that their counselor left the agency. It became clear that there was no state-wide, systematic way of communicating vacancies to consumers. The CAP brought this to the attention of VR administrators at an Executive Leadership Team meeting, and asked the agency to consider initiating a formal process to 1. Inform consumers when their counselor leaves VR employment and 2. To inform consumers of who will be working with them until a new counselor is hired. The agency responded very favorably to this idea
B. Litigation
0
0
0
<P><p>
Part V. Agency Information
A. Designated Agency
Internal to the State VR agency
NC Department of Health and Human Services
No
N/A
B. Staff Employed
CAP Director Two Client Advocates Processing Assistant All four positions are full time positions. The Director, one advocate and processing assistant positions were filled 100% of the time. Due to one advocate retiring and the extensive process of hiring one advocate position was vacant 75% of the time <p><p>
Part VI. Case Examples
Case Examples
This case is offered as it relates to recent discussions seen on the national CAP listserv. 57 year old client with a diagnosis of mental illness contacted the CAP because the VR agency was stalling her application for services. VR had served this client in the past and there was some indication of a negative bias toward her, especially in light of the fact that she was requesting assistance with obtaining a graduate degree, and the VR agency had assisted her with training in her prior case. Client was told she did not need to apply to VR until she obtained an acceptance letter from the school. The client then called the NCCAP. She was concerned about the time frames involved related to her potential school start date . Our advocate intervened to help the client apply for services. The VR agency then put another obstacle in the way by demanding that the client complete the FAFSA. Given that usual financial aid is not available at the graduate level, we felt this was obstructive, as the VR counselor insisted that she complete the FAFSA before her VR application date., stating, &ldquo;the school uses the FAFSA information in determining any need-based (I think some merit-based as well) grants or scholarships and those comparable benefits must be investigated.&rdquo; There were other complicating factors as well. Given our perception of the agency&rsquo;s negative bias in this case, we helped the client prepare for any other eventual obstacles. We advised her to obtain a letter from her physician stating that there were no mental or physical reasons to believe she could not be successful in a graduate program. Finally we contacted the VR Chief of Policy to weigh in on the case. The COP agreed that completing the FAFSA should not be an obstacle either for VR application or financial eligibility. Our advocate relayed this information to the VR Unit Manager and counselor and facilitated communication between the VR office and the COP. The case is now moving forward. <p><p>1.Reason case is interesting: * disagreement between an IL counselor and a rehabilitation engineer * engineer not taking a holistic view of the client. * IL counselor referral to CAP to negotiate a solution. An IL counselor referred the sister of a 57 year old IL client to the CAP to help resolve a disagreement with the agency over a stair lift installation that the client will not use. The IL client is dealing with orthopedic impairments and mental illness. The sister reported disagreements with the IL rehab engineer throughout the process. The CAP investigated her concerns, contacted the Unit Manager and IL counselor, and also conferred with the Chief Engineer in Raleigh who agreed to take a fresh look at the case. Due to the area configuration, and in an effort to cut costs, the stair lift as installed did not go all the way to the bottom of the stairs, but required that client to stand and take the last few steps. Due to the client&rsquo;s mental issues, she would n
Certification
Approved
Tara Myers
Director
2017-11-28
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