RSA-227 for FY-2019: Submission #1049

Arkansas
9/30/2019
General Information
Designated Agency Identification
Disability Rights Arkansas, Inc.
400 West Capitol Avenue
Suite 1200
Little Rock
AR
72201
(800) 482-1774
(800) 482-1174
Operating Agency (if different from Designated Agency)
Disability Rights Arkansas, Inc.
400 West Capitol Avenue
Suite 1200
Little Rock
72201
{Empty}
(800) 482-1774
(800) 482-1174
Additional Information
Thomas Nichols
Susan Pierce
(501) 296-1775
{Empty}
Part I. Non-case Services
A. Information and Referral Services (I&R)
30
0
0
5
1
7
43
B. Training Activities
3
396
DRA staff presented at a cross-disability conference, hosted by the Arkansas Statewide Independent Living Council, about the rights of individuals with disabilities, including the right to access vocational rehabilitation services. Ensuring the 30 attendees are aware of the services available to them, including the CAP and other DRA services, constituted the purpose of the training; the audience consisted of individuals with a variety of disabilities. <p><p>DRA staff provided training to care coordinators employed by the Provider-led Arkansas Shared Savings Entity (PASSE) system, which is a new Medicaid managed care program. DRA's participation in this training ensured that these approximately 350 care coordinators, who will be coordinating services for a significant number of Arkansans with developmental and behavioral disabilities, are aware of vocational rehabilitation services and the CAP. <p><p>DRA staff provided training to 16 students at the Arkansas Career Training Institute (ACTI) on the CAP program. ACTI was a residential vocational rehabilitation center operated by Arkansas Rehabilitation Services (ARS), and was one of only eight comprehensive rehabilitation centers in the United States. Through the years, DRA staff provided training on the CAP during new student orientations; however, the decision was made by state officials to convert the facility to a non-residential program, which occurred during the summer of 2019.<p>
C. Agency Outreach
Several of DRA&rsquo;s collaborative projects from FY2019 spanned the state, including areas that are considered underserved. Arkansas transitioned in 2019 to a system of managed care for select populations of Medicaid beneficiaries those with behavioral health needs and those with developmental disabilities. One of the managed care organizations (MCOs) hosted a training for their care coordinators and invited DRA to speak about our P&A and CAP programs. In doing so, we were able to discuss the litany of options available to their clients who wish to seek employment. We educated participants about the state vocational rehabilitation agency, the services that should be made available through this agency, and what to do if services are denied or delayed. Participants were informed of the CAP and how it can assist their clientele. As these care coordinators serve individuals statewide, this training provided DRA with the opportunity to increase awareness about vocational rehabilitation services and the CAP for even the chronically unserved and underserved areas of the state. Other efforts included DRA&rsquo;s participation in a disability policy consortium, where we collaborated with participants to identify and understand specific problems and barriers that affect individuals with disabilities. This consortium drew individuals from across the state, including those areas that are underserved. An attorney who works in DRA&rsquo;s education and employment section, which is responsible for nearly all our work under the CAP grant, was our primary presenter at this annual event. DRA continues to participate in Employment First activities to ensure that Arkansas encourages and incentivizes the employment of individuals with disabilities. We reviewed the state&rsquo;s past Employment First efforts, consulted with subject-matter experts, and developed strategies to assist other stakeholders in pushing the state toward a true Employment First policy. This activity both involves and impacts individuals in the most underserved areas of our state. Finally, we continue our appointment to the State Rehabilitation Council (SRC) and attendance at the Division of Services for the Blind (DSB) board meetings, as well as reviewing and commenting on proposed rules and policy changes at the state level that impact individuals who are seeking competitive, integrated employment. <p><p>
D. Information Disseminated To The Public By Your Agency
1
7
1
188
14
5245
By the conclusion of FY2019, DRA had 4,311 Facebook followers and 934 Twitter followers. <P><p>
E. Information Disseminated About Your Agency By External Media Coverage
DRA occasionally receives calls from Arkansas Rehabilitation Services (ARS) field offices, requesting CAP brochures. DRA was also mentioned in Arkansas Democrat-Gazette newspaper articles and by local television stations in FY2019; however, this was primarily related to DRA's work on juvenile justice issues rather than CAP issues. <P><p>
Part II. Individual Case Services
A. Individuals served
5
27
32
4
9
B. Problem areas
0
7
26
2
0
1
0
0
C. Intervention Strategies for closed cases
17
1
1
0
7
0
28
D. Reasons for closing individuals' case files
17
3
1
3
0
0
1
2
1
0
0
0
<P><p>
E. Results achieved for individuals
5
1
0
1
13
2
2
1
0
3
In one case, the client did not prevail in a hearing, in another case the client was unresponsive to the CAP, and in the third case the CAP determined that the client was refusing vocational rehabilitation services, so their issue did not have merit. <p><p>
Part III. Program Data
A. Age
1
5
12
14
0
32
B. Gender
19
13
32
C. Race/ethnicity of Individuals Served
0
0
0
8
0
22
1
1
D. Primary disabling condition of individuals served
1
1
0
0
0
0
5
0
7
5
0
1
0
2
0
0
0
0
0
1
3
0
1
0
1
1
0
0
0
2
0
1
0
0
32
E. Types of Individuals Served
13
0
20
0
1
1
Part IV. Systemic Activities and Litigation
A. Non-Litigation Systemic Activities
1
The CAP was concerned about our state&rsquo;s heavy reliance on a comprehensive rehabilitation facility to provide services to individuals eligible for vocational rehabilitation services. Young adults who would otherwise benefit from receiving similar services in a community setting were often steered toward the facility, many times as a first resort. As a result, the CAP dedicated effort in FY2019 to investigating the use and effectiveness of this facility. After a number of targeted Freedom of Information Act (FOIA) requests, conversations with the U. S. Department of Justice (DOJ), DOJ&rsquo;s Office for Civil Rights, the Rehabilitation Services Administration, and a subject matter expert who had been retained to assist with closing a similar facility in Maryland, the CAP began working toward writing and publishing a report regarding our investigation and its findings. Before we could progress to publication, the Governor of Arkansas announced that the state would discontinue the residential use of the rehabilitation facility. As a result, the individuals who were housed at the facility, as well as those who would otherwise be routed to the facility, will now have more opportunities to receive services alongside their non-disabled peers. The CAP continues in FY2020 to assist those students who were not adequately transitioned back to their local field counselors for services. <P><p>
B. Litigation
1
0
1
In FY2019, the CAP discovered that the Arkansas Division of Services for the Blind (DSB) failed to obtain the necessary identification number to receive federal funding for its services after it changed divisions through a state government transformation mandated in the last legislative session. As a result of the loss of federal funding, the DSB created a new policy that permitted only nominal tuition assistance for the fall semester for the people they serve. The DSB did not promulgate this policy as a rule, in violation of state law, nor did the Division seek public comment or CAP input, in violation of federal regulations. Further, the limits placed on services did not permit exceptions, and were so low that the limits effectively denied those services to individuals; again, in violation of the federal regulations. Once the CAP discovered that individuals were effectively denied services, we called the DSB to discuss our concerns. They assured us they were working to fix the problem, but they refused to rescind the policy. DRA released a statement through its social media platforms informing the public of this development and asking for affected individuals to contact the CAP as soon as possible. While we were preparing to file suit regarding this issue, the federal government made funds available to the DSB, presumably fixing the problem. We discussed the issues with the Rehabilitation Services Administration (RSA), who echoed our concerns regarding the DSB&rsquo;s understanding of the regulations, especially those governing the mandated rule-making process. RSA also expressed concern about the fiscal management of the organization. To date, all DSB clients who contacted the CAP seeking assistance with tuition as part of their individualized plan for employment (IPE) have had their tuition paid in full. Days after the resolution of the tuition issue, the CAP discovered that, while tuition was being freely paid by the DSB, it decided to terminate orientation and mobility services for individuals who were newly blind; again, without promulgation or consultation with the CAP or the public. The CAP was informed by the assistant director at the DSB that there was an ad hoc priority system established wherein tuition payments would receive top priority, followed by emergency services. Every other service available to individuals would be provided only if there were funds leftover in the individual counselors&rsquo; budgets. This violates the RSA regulations by failing to promulgate a rule that substantively affects the provision of services, as noted earlier. The CAP immediately filed suit against the DSB on behalf of a client who was unable to work or care for his child due to the lack of mobility services previously promised to him. The day after we filed the lawsuit, the DSB reversed course and began paying for individuals to attend these programs. All CAP clients who were similarly situated were informed that they were aga
Part V. Agency Information
A. Designated Agency
External-Protection and Advocacy agency
Disability Rights Arkansas, Inc.
No
N/A
B. Staff Employed
Professional Staff: 13.0 Clerical Staff: 3.5 All staff (Professional and Clerical) are full-time. No staff were 100% allocated to CAP Staff hours allocated to CAP: Professional 87.00%, Clerical 13.00%. Staff hours allocated to CAP as a percentage of all staff hours worked across all grants 7.2% <p><p>
Part VI. Case Examples
Case Examples
-A newly blind individual was seeking orientation and mobility services from the Division of Services for the Blind (DSB). The client chose to attend World Services for the Blind (WSB) in Little Rock but was informed that it was not possible because the DSB was not permitted to pay for childcare for the client&rsquo;s minor child while they were in Little Rock. Instead, DSB staff suggested the client should accept less expensive in-home training from a contractor who was a former DSB employee, contrary to the client&rsquo;s express wishes. A CAP advocate discussed informed choice with the client&rsquo;s counselor and DSB administrative staff. DSB staff then told the client that it would not be possible to send her to WSB due to DSB budgetary issues. The CAP advocate again contacted DSB, and the client was subsequently able to spend a month at WSB receiving training, with childcare provided for her child. <p><p>-An individual eligible for services through the DSB who urgently required eye surgery to prevent a total loss of sight was required by the DSB to obtain a denial from her health insurance company before they would agree to cover the cost of the surgery. The client&rsquo;s insurance carrier would not confirm whether the surgery would be covered until the claim was submitted post-surgery. A CAP advocate contacted the client&rsquo;s counselor and discussed the conflict between the comparable benefits regulations and the State&rsquo;s policy or practice that is prolonging the client&rsquo;s access to an urgently needed surgery. The DSB counselor agreed that the client&rsquo;s need for assurance that the DSB would pay for the surgery if her insurance carrier denied the claim in whole or in part was reasonable and agreed to amend the client&rsquo;s Individualized Plan for Employment (IPE) to ensure the client would not be responsible for the cost of the surgery. <p><p>-An individual with a diagnosis of autism who was receiving residential vocational rehabilitation services at our state&rsquo;s comprehensive rehabilitation facility had always required accommodations for some challenging behaviors, which were previously addressed in a behavior plan implemented in secondary school. The client was not provided with adequate behavior supports at the facility, however, which resulted in his being discharged after facility staff alleged that he became so intoxicated off campus that he needed emergency medical treatment from a local hospital. The client maintained he was not intoxicated but was instead having a panic attack. A CAP attorney represented the client in an appeal to the facility administrator, at which time it was determined that medical records had been misinterpreted by unqualified staff and the client was being unfairly discharged. The client was subsequently permitted to return to the facility for services. <p><p>
Certification
Approved
Susan Pierce
Grants Manager
2019-11-22
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