RSA-227 for FY-2025: Submission #53

2. Describe the systemic activities conducted by CAP during the fiscal year and its impact on other agency's policies or practices. During FY25, Vermont's CAP experienced a period of transition, when our CAP representative of over 35 years retired. We have since added and trained a new CAP representative, who brings new vision and energy to the role, building off of the significant accomplishments of her predecessor. CAP again engaged in a wide variety of systemic activities, some multiple times, to reach different audiences in FY25. CAP attended several meetings of the HAVT SRC (State Rehab Council) including
quarterly Policies and Procedures Committee, Performance Review Committee, Advocacy Outreach and Education Committee and Steering Committee meetings. CAP also attended monthly and quarterly meetings of the Division for the Blind and Visually Impaired (DBVI).

NON-LITIGATION SYSTEMIC ISSUES ADDRESSED BY CAP THAT RESULTED IN THE CHANGE OF ONE OR MORE POLICY OR PRACTICE OF AN AGENCY:

1) HAVT Self-Employment Policy (Chapter 308)

Over the course of multiple years, CAP led an ad hoc group involving key representatives of HAVT that worked to update HAVT’s 2009 policy regarding self-employment. With the assistance of Griffin-Hamis Associates (GHA), a nationally recognized expert regarding self-employment and customized employment for people with disabilities, HAVT -

Revised the policy;

Developed general and intensive training modules for staff;

Created a program manager position to facilitate the implementation of the revised policy;

Developed resource manuals for staff and participants;

Recruited and selected counselors to participate in intensive training to act as regional resources regarding self-employment;

Defined a panel to review and approve self-employment proposals

Substantially increased funding guidelines for self-employment increased;

Approved several self-employment proposals; and

Presented the HAVT model at conferences.

In the 1st quarter of F’25, the review panel began reviewing and funding self-employment proposals. CAP will continue to monitor the implementation of the revised policy. During the 2nd and 3rd quarters of FY’25, CAP shared the Vermont policy and model with counterparts in other states, and HireAbility VT has spoken with over 14 states expressing interest in the model. Training for general and specialist counselors is underway with the Division of the Blind and Visually Impaired joining in the training and implementation of the model.

2) HAVT Transportation Policy

During the 1st quarter of FY’25, as Chair of the HAVT Policies and Procedures (P&P) Committee, CAP commented on HAVT Transportation policy. Revisions will be made and returned to the P&P committee in the coming quarter.

In the 2nd quarter, the committee approved the revised policy which was implemented following public comment. However, HAVT proposed further revisions to the policy in the 3rd quarter, specifically, removal of the spending guideline of $15,000 toward the costs of base vehicles for those who need adapted/modified vehicles to reach an employment outcome. CAP objected to the proposal as inconsistent with the existing policy setting a spending guideline of $5,000 toward purchase of unmodified vehicles. CAP asserted that proposed elimination violated WIOA regulations permitting purchase of vehicles as a covered service, including contributions toward base adapted vehicles. CAP further argued that setting an arbitrary limit on the nature and scope of services is an issue. See, 34 CFR §§ 361.5 (c) (56) (i) and 361.48 (b) (8). Finally, CAP recommended that the policy permit a spending guideline of $5,000 to the cost of the base vehicle contribution to ensure consistency with existing policy and in recognition of a significant loss of funding experienced by the agency. The proposed change was accepted by HAVT, but the committee disagreed and advocated keeping the spending guideline at $15,000 to which HAVT agreed.

OTHER NON-LITIGATION SYSTEMIC ACTIVITIES CONDUCTED BY CAP DURING THE FISCAL YEAR:

1) Inadequate Services for Vermonters with Mental Health Disabilities

Over multiple FYs, CAP has raised concerns with HireAbility VT (HAVT) about observed poor outcomes for and the unmet service needs of individuals with mental health diagnoses.

CAP was unable to work on this initiative in the 1st quarter of FY’25.

In the 2nd quarter of FY’25, CAP observed a trend where participants with diagnosed and undiagnosed mental health disabilities received notices terminating HAVT services based on asserted non-cooperation. The alleged non-cooperation consisted of behaviors that were easily tied to the nature and severity of these participants' disabilities, which did not support the finding of non-cooperation. Instead, the assertions supported the finding that the participant was not receiving the appropriate support and that the counselors needed additional training on how to work with participants with challenging behavior. In some instances, there was a question as to whether the true basis for the service determination was the belief that the participant was too disabled to benefit from services but because the procedural requirements for termination under this standard were more complicated, the agency was opting for the non-cooperation standard.

In the 3rd quarter of FY ’25, CAP resurrected its concerns with the PRC and the committee requested HAVT provide updated data for review. CAP also raised the issue in monthly meetings with the Field Services Manager and in the CAP/HAVT quarterly meeting with the Director, Deputy Director, and other central office administrators. It was acknowledged that inability to benefit was the more accurate basis for the decisions to terminate services and that the agency struggles with those who have undiagnosed/untreated mental illness and/or personality disorders. It was the agency’s belief that they had let cases not moving forward go on too long before acting which made the procedures under the unable to benefit criterion more complicated to implement.

The PRC continues its work on this issue

2) HAVT and Division for the Blind and Visually Impaired (DBVI) Confidentiality Policies and other Policy Review:

Over several years, CAP raised concern about HAVT’s and DBVI’s confidentiality policies, which are the same. Over those years, the policy has been discussed within the HAVT Policies and Procedures Committee and with the Director of DBVI. The primary concern is the lack of a participant's complaint procedure if a breach of confidentiality is alleged. No ultimate action was taken by either.

Both HAVT and DBVI follow HIPAA (Health Insurance Portability and Accountability Act) rules. Unlike other states, the Divisions are structurally organized under the VT Agency of Human Services (AHS). While the Rehabilitation Services Administration (RSA) has issued guidance indicating that under WIOA these entities are not subject to HIPAA requirements. The guidance, however, gives each state the right to select whatever policy it deems appropriate. While there appears to be a complaint procedure under the AHS structure, that complaint procedure is not readily accessible to HAVT or DBVI counselors, program participants, or the public.
Throughout FY’24, this policy came up for discussion within the Policies and Procedures Committee, but ultimate action was delayed due to the unavailability of the HAVT Policy Director.

The discussion resumed in the 1st quarter of FY’25 with CAP making specific recommendations for change, including:

Revising the definition of “personally identifiable information,”

Adding a definition of “informed consent,”

Adding a section on breach of confidentiality including reference to the Agency of Human Services (AHS) complaint procedures;

Adding reference to the AHS (encryption) policy when disclosing information electronically, and

Revising the policy to require consultation with legal counsel before any testimony by staff or disclosure of records in legal proceedings.

The proposed revisions were reviewed and approved by the committee in the 3rd quarter of FY’25. It is expected that DBVI will adopt the revised confidentiality policy.

In the 3rd quarter of FY’25, CAP completed a review of all DBVI policies to ensure compliance with WIOA regulations. CAP noted the absence of policies regarding referral and application, and “informed choice.” CAP submitted proposed policies in these areas. There is also an inadequate policy regarding confidentiality and CAP proposed adoption of the new HAVT policy. Multiple policies contain specific funding limits and no procedural criteria for making exceptions to spending guidelines in violation of WIOA regulations and RSA guidance. CAP reviewed with the Director and staff the VT rulemaking procedural requirements, recommended restructuring of the policies and procedures manual making it sequential thus easier to follow and identified priorities for policy revision by the Division.

3) CAP Outreach

Due to limited resources, no formal outreach activities were conducted in the 1st and 2nd quarters of FY’25.

In the 3rd quarter of FY’25, CAP maintained an informational table at the annual conference for the Vermont Family Network (VFN) (VT-PTIC) attended by 197 parents, educators, service providers, agencies, and youth with disabilities. We distributed written information about –

How Can I Get the Most Out Working with HireAbility Vermont?

How Should I Prepare for a Meeting with My Counselor?

5 Tips for Self-Advocacy

Frequently Asked Questions About Pre-Employment Transition Services

ABLE Accounts: Are They for You?

Client Assistance Program (CAP) Brochures

4) DBVI VT Pathways to Partnership (VT-P2P) Grant:

The Division for the Blind and Visually Impaired (DBVI) received a 5-year grant from the U.S. Department of Education Rehabilitation Services Administration (RSA). The focus of the Disability Innovation Fund (DIF) grant is to improve services and attain successful outcomes for youth/student with disabilities through development of training and best practices that can be implemented in all VT high schools and tech programs.

The grant requires collaboration (developing partnerships) between agencies, schools, parents, consumers, and other advocacy groups, independent living centers, and others. CAP serves on the steering and leadership committees.

In the 1st quarter of FY 25, students were recruited to participate in the pilot and construction of a website was initiated. The committees continued to meet and at each leadership meeting youth are invited to present their perspectives. Subcommittees were established to focus on disability pride and self-advocacy, work-based learning, and training. DBVI also contracted with HireAbility VT to assist with in-school presence through their school-based pre-ETS transition counselors.

In the 2nd and 3rd quarters of FY’25, CAP participated in meetings of the P2P steering, leadership, and disability pride/self-advocacy committees. CAP also participated in a training event for HireAbility VT (HAVT) school-based transition counselors engaged in pre-ETS services for eligible students. Website construction was completed, and committees on work-based learning, professional development (training), disability pride/self-advocacy continue to meet.

In the coming school year, the pilot will be expanded to include 22 high schools across the state with an HAVT transition counselor assigned to each high school.