ALL ROADS LEAD TO INDEPENDENCE

The vision of MRC is to promote equality, empowerment, and productive independence of individuals with disabilities. These goals are achieved through organizational innovation committed to creating options that enhance and encourage personal choice and risk taking toward independence and employment.

The purpose of the Massachusetts Rehabilitation Commission is to provide comprehensive services to people with disabilities that will maximize their quality of life and economic self-sufficiency in the community.

This is accomplished through multiple programs in the three divisions of MRC: the Vocational Rehabilitation Services Division, the Independent Living Division, and the Disability Determination Services Division.

ELMER C. BARTELS Commissioner of Rehabilitation
JOHN A. CHAPPELL, JR. Deputy Commissioner, Independent Living Services
CLAIRE T. GHILONI Deputy Commissioner, Administration & Finance
KASPER M. GOSHGARIAN Deputy Commissioner, Disability Determination and Vocational Rehabilitation Services
JANNA ZWERNER Chief of Staff

TABLE OF CONTENTS

Message from Commissioner Bartels

Vocational Rehabilitation

Independent Living

Disability Determination Services




Message from Commissioner Bartels

It is once again my great pleasure to present the Massachusetts Rehabilitation Commission (MRC) Annual Report for Fiscal Year 2002. As we continue another decade of successfully serving individuals with disabilities who live in the Commonwealth of Massachusetts, we are grateful for the support we have received and the opportunity to make a difference in the lives of so many people. The Massachusetts Rehabilitation Commission provides unique and valuable services, each tailored to the specific needs of individuals with disabilities at various stages in their lives. Last year, MRC staff helped nearly 4,000 people with disabilities find or retain employment, another 15,000 to live independently and provided disability determinations to 82,000 Massachusetts residents so they may have the financial resources to survive after incurring a disability. From disability examiners and case managers to investigators and vocational rehabilitation counselors, MRC's highly-skilled professional employees are key to our service delivery system. This year, we asked both our staff and consumers to tell the MRC story through this Annual Report. The two are inextricably woven together in their joint effort to make Massachusetts a better place to work and live for all of us.

Indeed, the various communities throughout the Commonwealth have greeted us with open arms. As a whole, the business community has embraced the philosophy of Public Vocational Rehabilitation and helped to advance our cause, perhaps more than any other group. Without their dedication and partnership, some 4,000 people with severe disabilities placed this past year would still be without a job, missing the chance to showcase their skills and to become financially independent. And possibly, thousands upon thousands more would never even get the chance to try and do so.

One way in which the MRC acknowledges its employer partners is by nominating businesses who set a positive example while embracing the practice of hiring qualified persons with disabilities for the Massachusetts Governor's Exemplary Employer Awards. This honor is awarded by the Governor every year to employers who hire persons with disabilities and provide employees with competitive wages, benefits and an opportunity for advancement. Last year, six MRC employer partners who were nominated by the MRC won these coveted awards: Bay State Health Systems in Springfield, Summer Realty Trust in Fitchburg, The Williams Inn in Williamstown, Providence Ministries for the Needy, Inc. in Holyoke, ISA in Hopedale, and the Groton School in Groton, all employers who meet the criteria of being an exemplary employer. This public acknowledgment strengthens our partnerships with these employers while informing both the disability and employer communities that people with disabilities can and do work successfully in every sector of the Massachusetts economy.

Most importantly, the Massachusetts disability community has been our steadfast partner and continues to give us their wholehearted support. While the MRC exists to provide services to this multifaceted group, their collaboration and constructive criticism has served this agency well, assisting us in shaping our programs and refining our services over the years in the most meaningful ways.

Each year we distribute a consumer satisfaction survey, the result of a consumer-led cooperative effort between MRC staff and consumers serving on the Statewide Rehabilitation Council. The results of this year's survey support our claim that the MRC staff and service delivery system are highly efficient and valued by those who use it. Just fewer than 2,000 constituents were asked if they would recommend MRC to a friend and 93.2% answered in the affirmative. Professional staff, once again, were said to be our greatest resource.

These difficult economic times have been doubly troubling for an agency such as ours. People with disabilities traditionally have had some of the highest jobless rates in the nation, thus, when the unemployment of the general public rises, it makes it even tougher to fulfill this part of our mission - finding jobs for individuals with the most severe disabilities. In anticipation of these financial challenges, we ceased hiring staff to assist us in carrying out this job several months before the onset of this fiscal year. Thus, we have downsized the agency by more than 80 people over the course of the past year, shrinking our payroll budget while increasing the purchase of service budget to maintain the scope of services, but not at the expense of our commitment to serve.

Regarding our efforts to generate funds in order to continue providing services and expand certain programs for our consumers, we have applied for and been awarded several federal grants. These grants range from the Benefits Planning, Assistance and Outreach Project to the Transportation Options Project (TOP) providing consumers with needed transportation resources, to assisting them in determining the financial resources available through various governmental and private sources. These grant awards have generated more than $1,769,000 for MRC, allowing us to continue offering vital rehabilitation services to our constituency, who would otherwise have been denied services.

It has been an honor to serve the Commonwealth for 25 years in my current capacity. I am grateful for this opportunity to have a fulfilling and dynamic career and am as committed as ever to ensure that citizens with disabilities in Massachusetts continue to have similar employment opportunities as well.


Vocational Rehabilitation Program Overview

The Public Vocational Rehabilitation (VR) Services Program of the Massachusetts Rehabilitation Commission receives approximately 75% of its funding from the federal government through the Rehabilitation Services Administration in the Office of Special Education and Rehabilitation Services, under the federal Department of Education. This effort to assist people with disabilities in becoming employed and financially independent dates back to the Smith-Fess Act (PL 66-236) passed by Congress in 1920. This Act was the federal government's first attempt to address employment barriers facing people with disabilities.

The VR Program has greatly expanded its services over the years in response to the call for assistance from people with the most severe disabilities, once believed to be "unemployable." With advances in public policy, social attitudes, and assistive technology, as provided by the Rehabilitation Act and its subsequent amendments, employment barriers facing persons with disabilities are not as great as they once were, but many still remain. Nonetheless, in FY 2002, the MRC-VR program helped more than 4,000 people with disabilities get jobs and collectively earn approximately $82 million in their first year of employment. With an average wage of more than $10 an hour, last year, these motivated employees paid $15 million in taxes to the Massachusetts and Federal Treasuries.

On August 7, 1998 President Clinton signed into law the Workforce Investment Act (WIA) of 1998 (Public law 105-220). Title I of this Act provides assistance to states interested in establishing statewide and local workforce investment systems. Title IV of the Workforce Investment Act contains a new version of the Rehabilitation Act of 1973, the legislation authorizing the federal-state Public Vocational Rehabilitation Program. The intent of WIA is to streamline and expand access to numerous workforce investment and educational programs for job seekers, including individuals with disabilities, as well as for employers, with the establishment of a One-Stop service delivery system. This law has helped to create a collaborative partnership between the VR Program and other entities involved with the statewide workforce investment system.

Several years ago, the MRC established Project IMPACT, a program funded by the Social Security Administration in an attempt to overcome the disincentives built into receiving public benefits (see story, pg. 12). This program was initiated after the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA) became law. This law launched new opportunities and programs, such as Project IMPACT, offering financial planning, technical assistance and outreach for persons with disabilities who receive Social Security disability benefits and are interested in working or returning to work.

Accessible transportation is always of great concern to persons with disabilities who want to go to work. In spite of funding constraints, the MRC maintained its Assistive Technology program, providing vehicle modification services, driver evaluations and other types of adaptive assistance. Through MRC's work with its Transportation Options Grant (TOP), 3,021 persons with disabilities were served, finding solutions to the transportation problems of 2,830 consumers. Thus far, six of the state's transportation systems were evaluated in an effort to expand transportation options for people with disabilities trying to obtain or maintain employment.

Consumer involvement is built into the provision of VR services at many levels, and in accordance with Section 105 (c) of the Rehabilitation Act, the VR Program has a very active State Rehabilitation Council (see pg. 21). This past year, approximately twenty gubernatorial appointees served on the State Rehabilitation Council and provided oversight and guidance to staff working in all areas of the Vocational Rehabilitation Program.

Several area offices and regions in the MRC's Public VR Program also have active Advisory Councils consisting of persons with disabilities, their family members, employers, providers and others interested in helping to improve MRC-VR services.


A Winning Public Partnership

These days, reaching out to the employer community on behalf of individuals with disabilities often seems a monumental task. Developing relationships with local and regional employers is a vision shared by all 26 MRC Vocational Rehabilitation (VR) field offices.

In general, Massachusetts and the MRC have been pioneers in the area of collaboration between the Public VR Program and local career centers. In particular, this story highlights how the Fitchburg VR Office and the Career Center of North Central Massachusetts have united in support of this. Their successful public partnership is both nurtured and cultivated by working closely together to provide "value-added" services for the customers they have in common, who include people with disabilities, as well as employers.

Mr. Bill Allen, MRC Placement Coordinator in the Fitchburg VR Office, meets weekly with local Career Center staff. "Being available and aware of job openings in a timely fashion is crucial to meeting employer expectations, as well as providing immediate job information to a qualified MRC job seeker," explains Allen. All of these job leads are reviewed and then shared with the Vocational Rehabilitation Counselors (VRCs) and job seekers who attend the weekly placement meetings in Fitchburg. John Hackett, Director of the Fitchburg VR Office, relays his favorite story attesting to the success of this partnership:

"During his weekly visit to the Career Center, our Placement Coordinator, Bill Allen, met with the Career Center Employer Representative Judy Evans. Judy identified an employer, a retail recreational vehicle company, who had just posted an accounting position. As they were talking, they looked at the company profile which revealed they could provide a sensitive and calm work environment for the right individual. When Bill returned to the office, he met with one of our Vocational Rehabilitation Counselors and shared the job announcement with them. They both knew right away who could do this job. The Counselor telephoned the MRC consumer and scheduled a meeting with her to discuss the job lead. The consumer, who has a bilateral hearing loss and utilizes hearing aids, as well as a generalized anxiety disorder and depression, responded immediately, even though she felt the job was too good to be true. Interestingly enough, as the Career Center had suggested, the work environment was quite suitable and accommodating of her disabilities. She was anxious and nervous about contacting the employer, but with encouragement from Bill and her VRC, she made the phone call. When she hung up the telephone, she was beaming from ear to ear. 'I got an interview' she exclaimed!

Within twenty-four hours, due to the efforts of staff in this united community partnership, she received a bona fide interview and, most importantly, was hired for the job a week later. Now, that's what I call real-time job information!"

When an employer performs recruiting activities at the Career Center, the MRC is typically invited to participate in the planning and design of the employer's recruitment effort. The Career Center Director, Rosemary Chandler, also attends placement meetings at the local MRC office from time to time to explore and assist with alternative training opportunities in order to better serve MRC consumers.

This partnership with MRC also offers the Career Center the presence of a Vocational Rehabilitation Counselor on-site on a weekly basis. Each Wednesday afternoon, an MRC-VR Counselor is available to provide vocational rehabilitation counseling and guidance services to potential customers of the Career Center who may be in need of such services. Additionally, the MRC also sends counselors to the Career Center's satellite office in Gardner, MA on a weekly basis. There, the VRC provides technical assistance and expertise with respect to disability-related or clinical issues. In many situations, this partnership assists with making appropriate referrals to other state agencies such as the Department of Mental Health or the Department of Mental Retardation.

Another positive outcome of this public partnership has been the development of new 'products' designed to benefit customers. Disability sensitivity training has been presented by MRC to both Career Center staff and employers who use their services. This training was designed to enrich the communication process with individuals with disabilities. It also provides an educational forum allowing Career Center staff to engage in a professional interview with someone who happens to have a disability. As always, the focus of this and other training developed by the MRC is to break down barriers and increase comfort levels for people not always used to working with individuals with a variety of disabilities.


Long and Winding Road

Vincent Spencer never thought he would have to alter everything in his life in order to perform simple, everyday tasks, but after a fall off a ladder left him quadriplegic, he had to do just that. He wanted to remain in his home and in the job he loved as Assistant Headmaster at Cambridge Rindge & Latin School, but knew he would need a lot of help to make the necessary adjustments to his environment.

Four months after his injury, while still in the hospital, Vincent sought the help of Cindy Martin, a VR Counselor in the MRC Somerville office. Tirelessly working behind the scenes, Cindy managed every intricate detail down the long road of Vincent's rehabilitation, coordinating all the services he needed while keeping a close tab on his personal progress. Vincent's initial request for assistance was adaptations to his house. Since his home was only accessible by climbing stairs, major modifications would be needed. In July of 1999, following nine months in the hospital and rehabilitation facilities, Vincent was able to return home with the help of the MRC and the Visiting Nurse Association. With the assistance of Steve Scarano, Home Modification Program Coordinator for the MRC, the renovations to Vincent's house were made possible. In September, the MRC began planning Vincent's home modifications, which would have to include a wheelchair lift and widening of all the doorways, as well as extensive bathroom renovations, all in order to get Vincent back to a more independent life. The MRC designed the blueprints for the wheelchair lift, in which the front steps to the house were taken away and replaced with the lift. Additionally, the MRC expanded the doorways to Vincent's home to accommodate his motorized wheelchair. The most drastic changes in his home were made to the bathroom in order to meet Vincent's specific needs. The tub was removed and a roll-in shower with a hand-held water spray was put in its place. There was also a new toilet installed that stood several inches higher than a standard model. Grab bars were secured to the walls in the shower and next to the toilet for safety as well as support. The sink was replaced with a wall-hung sink to enable Vincent to roll his wheelchair underneath, without a cabinet obstructing his clearance. Likewise, the medicine cabinet was lowered to eye level so Vincent could see himself in the mirror. The MRC made a huge effort to renovate everything that might potentially stand in the way of Vincent's new adjustment to his surroundings.

The next step in Vincent's overall rehabilitation process was to focus on the goal of returning to work. An Individual Plan for Employment (IPE) was initiated with his VRC, Cindy, outlining all of the specific steps which would be taken by both of them in order to achieve his particular employment goals. To begin implementing the IPE, Vincent would now have to enter the new world of assistive technology to meet his transportation and employment needs. Eugene Blumkin, a seasoned rehabilitation engineer who has worked for the MRC for 11 years, stepped in to play a pivotal role, being responsible for providing Vincent with the assistive technology he now required.

An evaluation was scheduled by the MRC and carried out by Easter Seals. The Massachusetts Easter Seals provides contracted assistive technology evaluation services to the MRC. Their assessment determined Vincent would need Internet access, as well as word processing and database software to reach his vocational goal. Because Vincent has very limited hand dexterity but excellent vocal function, it was determined a voice-activated computer would provide the best productivity. MRC purchased the needed computer equipment including a monitor, printer, modem, scanner and the like, and Vincent was trained in the use of Dragon's 'Naturally Speaking' software. This program allows Vincent to use his voice to draft letters, spreadsheets, forms and even e-mails because it offers some of the top speech recognition technology in the field. Once Vincent became competent in his use of the computer, he returned to work part-time in September of 2000. Fortunately for Vincent, Cambridge Rindge & Latin was very cooperative in providing the accommodations Vincent needed to return to the school. All of his duties can now be performed on the first floor of the building. He was also provided with special phone equipment to make and receive calls, as well as an assistant who is available to help him out whenever needed. Vincent still needed transportation to get to and from work, so he purchased a van to be modified by the MRC specifically for his use. There were many adaptations made to the vehicle to enable Vincent to get into the van on his own and drive. High-tech equipment was installed in his van, including gas and electric brakes, automatic doors, a lowered floor, wheelchair lift, and most notably, the Servo Steering System.

The Servo Steering System allows the driver to command the vehicle by way of a remote-control-like disc that can be operated with minimal hand movement. A driver evaluation was completed and driving lessons are being provided in order for Vincent to become proficient in the use of the new equipment. After completion of the driving lessons and sufficient practice, Vincent will be prepared to take and pass the required Competency Road Test.

Vincent has been able to slowly work his way back into his life at Cambridge Rindge & Latin. He still works from home a few days with the help of his computerized communication equipment. "The first day I met Vincent at Spaulding Rehab Hospital, everyone knew Vincent, including the parking attendant! I knew that day he was a very motivated and well loved man," states Cindy. Because of the MRC and people like Cindy, Steve and Eugene, the future looks bright for Vincent and he is gaining more independence everyday.


Project IMPACT Reaches Out

The MRC Project IMPACT (Individual Members Planning and Assessing Choices Together) team meets regularly, attending a staff meeting, sharing stories and catching up on the newest developments regarding Social Security disability programs (SSI/SSDI). Typically, the phone will ring in the midst of the meeting and Kim Thacker, one of the team members, instinctively will pick it up with a cheery "Good morning, this is Kim, how may I help you?" Kim looks at the rest of the team and winks, continuing to respond to the caller, "You want to know how working will affect your benefits? Sure! Let's set up an appointment... sometimes it's a little more complicated than what I can explain in a quick phone call." The team members smile at one another knowingly.

When Kim gets off the phone, the team looks at each other and nod their approval. What they had all expected to be a straightforward and simple job - complete a consumer interview, explain Social Security work incentives, and move on to the next customer - has transformed into an extremely complex project.

The Social Security Administration (SSA), authorized by the Ticket to Work and Work Incentives Improvement Act of 1999, awarded 116 Benefits Planning, Assistance and Outreach (BPA&O) cooperative grant projects to a variety of community organizations across the country. These BPA&O projects provide SSA beneficiaries with disabilities access to financial planning services. The Massachusetts Rehabilitation Commission was awarded one of these cooperative agreements and used it to create the Project IMPACT, staffing it with a group of seasoned professionals who have come together to work as a new team.

As Project IMPACT enters its third year, it has far exceeded all goals and expectations. The Project was recently named an "Outstanding Program" and ranked as the #1 Benefits Planning, Assistance and Outreach Project in the nation by the Social Security Administration. Using innovative and timely strategies to provide people with disabilities with valuable information regarding public disability benefits, Project IMPACT has become an integral step on the path to independence for many MRC consumers.

How did all of this come about? Over the years, numerous studies suggested that people with disabilities who receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) are hesitant to pursue a job because of misconceptions regarding their loss of Social Security benefits upon employment. These studies also indicated the work incentives available to SSDI and SSI beneficiaries were too complex and often resulted in more confusion as to the effect a job has on one's benefits.

"We see it over and over again. The two biggest concerns have to do with the fear of losing cash payment status or medical coverage," says Joe Reale, IMPACT project director. "Most times, when we provide only a modest amount of the right information and some technical assistance, consumers get a clearer understanding of their situation, enabling them to make the right decision," he further explains.

The Project provides up-to-date information about public disability benefits including SSI, SSDI, Medicaid and Medicare. It also provides information on Transitional Aid to Families with Dependent Children (TAFDC), Temporary Assistance to Needy Families (TANF), Emergency Aid to the Elderly, Disabled and Children (EAEDC), Food Stamp benefits, CommonHealth, MassHealth, state and federal public housing, Section 8 housing vouchers and much more.

In 2001, staff attended a week-long training sponsored through Cornell University and the Social Security Administration. Every afternoon the trainees were bombarded with complex benefits program information (TWP's, IRWE's, PASS & BWE's to name just a few). IMPACT Benefits Specialists also receive continuous training and are constantly looking for ways to better serve consumers. They can create personalized benefit plans to assist consumers in making the most informed choices regarding employment. In addition to assisting consumers, family members and community professionals navigating the public disability benefits system, Benefits Specialists also assist consumers in planning their long-term benefits toward self-sufficiency.

A PowerPoint presentation, "Work Incentives 101," is often used to explain the basics of Social Security benefits. Ideally, a consumer should be referred for individual benefits planning before they seek work, so they may plan ahead and make informed decisions regarding their benefits.

With the information provided by IMPACT, the MRC hopes more people with disabilities will choose to join the workforce. Knowing what to expect, a consumer may base their decisions on accurate information and be able to refer back to their concise, individualized benefits plan over time. By having all the information about benefits and services explained at one time in a straightforward manner, each consumer is able to make an informed choice about going to work.

Ultimately, that is what Project IMPACT is all about; presenting to the consumer, their families and providers all the benefit information they need to make an educated decision regarding employment. IMPACT's approach seems to be working, as they have surpassed their numeric goals for the second year in a row, developing plans for more than 744 people with disabilities during this time period.


Looking Beyond Labels

"Labels limit people. I am an honor's graduate of the Massachusetts College of Liberal Arts, the proud single mother of a bright and creative freshman at Northeastern University, the loving daughter of an aging mother who requires my assistance periodically, the accountant for a small private school nestled in the beautiful Berkshires...and YES, I also happen to have a mental illness," states Joan, an MRC consumer for more than five years.

When Joan came to the MRC's Vocational Rehabilitation (VR) Services Program in 1997, she was collecting SSI benefits but believed she could improve herself and her life by attending school and getting a job. However, she knew she would need a great deal of help to bring her through such a dramatic transition. The case manager she was working with in another agency suggested she might benefit from MRC services. Due to Joan's psychiatric disability, she needed the type of long-term supports the VR Program provides to tackle issues such as her low confidence level, along with preparation for the demanding world of work.

While Joan was attending classes, she was supported by her VR counselor, Jim Borowski, of the North Adams VR office, who assisted in coordinating all of the services she needed from various agencies. Joan amazingly made great strides despite the financial constraints which constantly threatened her progress. She made every effort to plan ahead and manage her small household budget wisely. Despite numerous episodes of diminished health and time absent from her academic program, Joan returned on every occasion to resume her plan, often in the face of considerable residual social impairment. She is a true example of courage and strength. Jim met with Joan regularly, establishing and revising goals, reviewing her academic progress and providing the much needed support and guidance Joan required to build up her self-esteem and confidence levels. She also began frequenting the local MRC Job Placement Group where she could learn and share ideas with other people who were also ready to join the work force.

After receiving her degree, Joan was referred to Cindy Bucier, the VR Job Placement Coordinator in the North Adams and Pittsfield offices of the MRC. Cindy's job is to provide one-on-one consultation with consumers who are about to organize their job search. The two met often to improve Joan's job seeking skills, review job leads, write cover letters, conduct cold calls, prepare for interviews and evaluate her progress.

After several months of job leads and numerous disappointments, Joan continued to receive technical and emotional support from Cindy. "Joan is a woman whose achievements are extraordinary given the recurrent nature of her disability. She is a beacon of hope to those who may have temporarily lost their faith," says Cindy. Joan and Cindy also had continuing discussions regarding disclosing the nature of her disability and presenting herself professionally, all while explaining the demands of the ongoing rehabilitation needs of a person with a severe and persistent hidden disability.

In the fall of 2002, Joan interviewed for a job as an accountant with a small private boarding school and was offered the position. While she did choose to disclose her disability to her employer and her association with the MRC, she did not request any job accommodations to carry out her duties as is her right, explaining to them only that her "condition requires rigorous attention." She knows she must be diligent about her continued recovery and some of the supportive resources she uses are only available during work hours. Joan is concerned with discrimination and is cautious as to why and with whom she discusses her disability. However, she also states, "by disclosing the fact that I have a psychiatric mental illness, I am reducing the stigma people with disabilities must face as part of their daily experience. Some of the most talented and famous people in American history have had some type of disability."

"Just because you have a disability doesn't mean you can't learn and can't be successful. Don't ever give up because we only have one life. Don't let a disability get in the way of living life to the fullest you can," states Joan. "If it wasn't for the Massachusetts Rehabilitation Commission, I would have been discouraged and perhaps given up on my search for employment and a fuller life."

Joan manages her disability effectively despite the negative and oppressive views she is challenged by so regularly in our society. She is serious about her own recovery and prioritizes her health care needs. "I have watched Joan gradually gain more and more confidence in her own abilities, and her self-perception become increasingly more positive. I commend Joan's success at the Massachusetts College of Liberal Arts and her subsequent employment as an accountant! No doubt, MRC has helped Joan to blossom, realize her potential and strive to be her best. We have enjoyed a great partnership with Joan," states Cindy.


Walking Down the Aisle to Independence

Abraham Lincoln once said, "If there is anything that a man can do well, I say let him do it. Give him a chance."

Corey Huntley has proven there are many things he can do well. Although Cerebral Palsy may challenge his motor skills and speech, it does not prevent Corey from tasting success in other areas. One of these is the sports arena. As a young boy Corey competed in sports, a passion he continued to pursue throughout his youth and into adolescence. His efforts culminated in the chance to compete in both the 5000 and 1500 meter bike races in three consecutive Paralympics: Barcelona (1992), Atlanta (1996) and Sydney (2000).

In a newspaper article printed before the games in Atlanta, Corey was quoted as saying, "The best thing about going to Atlanta will be getting a chance to beat the guy who beat me in Barcelona." In Sydney, Corey clinched the silver medal, proving his athletic prowess.

A competitive attitude and drive to succeed steered Corey toward the winner's circle and brought him success outside the athletic arena as well. After graduating from high school, he attended Springfield Technical Community College. During this time he worked closely with his Vocational Rehabilitation Counselor, Greg Devine from the MRC Springfield VR Office, to assess his career interests, skills and abilities.

Upon acquiring his Associate's Degree in Mechanical Engineering, Corey was introduced to Ellen Spencer, an MRC Job Placement Coordinator in the Springfield VR office, who assisted him with his job search. Unfortunately, despite submitting hundreds of resumes, Corey could not find a suitable job and continued delivering pizzas and training for his cycling competitions. "One of Corey's strongest assets is his upbeat, positive attitude in the face of what can be a very defeating job search process to a person with a disability. When others might have given up, Corey has shown he has the makings of a true champion, giving it his all, both on and off the track," says Spencer. "Give him a chance..." Finally, Bill Bernhardt of Titan Roofing, Inc. gave Corey a chance to prove his skills. Despite Corey's enthusiasm toward this new opportunity, there were still some obstacles to overcome. Corey was schooled in mechanical drafting; his job at Titan Roofing required knowledge of architectural drafting. Shortly after he started, Ellen checked in on Corey and learned that things were not satisfactory.

"Let him do it..." Instead of dismissing Corey as unqualified, Titan Roofing was convinced to partner with the MRC to provide the necessary training. Mr. Bernhardt received funding from the MRC for Corey to obtain specialized one-on-one training to learn the necessary architectural drafting skills. Because of Spencer's and Bernhardt's unwavering support and confidence, Corey has managed to double his earnings and achieve success in a career he enjoys.

The Massachusetts Rehabilitation Commission also provided Tamara Thomas of Ludlow with an opportunity to achieve success. As a toddler, Tamara was diagnosed with Spastic Cerebral Palsy, causing her to use loft strand crutches for mobility. As a high school student pondering her future, Tamara had always planned on continuing her education. However, in order to pursue her goal of becoming a social worker, she would need extra financial and emotional support. That's when Tamara's high school guidance counselor recommended her to the MRC. Due to a lack of funding, Tamara started school at Holyoke Community College; however, after two years, MRC made it possible for Tamara to obtain the necessary grants and financial aid to attend Bridgewater State College.

During this time, Tamara's VR Counselor, Jim Murphy in the Holyoke VR office, helped her realize her desired career would involve driving a car. MRC funded the necessary vehicle modifications and sent her to an adaptive driving program to learn how to drive. Tamara was then referred to Gaylord and Mercy Hospital for a driving evaluation to ensure she could operate the controls safely.

Tamara soon graduated from Bridgewater State with a degree in social work and began working as a paid intern at Abilities Unlimited where she gained practical experience in human services. Tamara designed pamphlets, had a caseload of clients and provided counseling services. After the internship ended, she landed a part-time job at FOR Community Services/Sunshine Village, which offers vocational and rehabilitative day programs. During this time, Tamara worked as an Activities Aide specializing in arts and crafts, and worked with consumers on their interpersonal and daily living skills as well.

Eventually Tamara realized she needed a full-time job where she could more fully utilize her social work skills. While working with Jim Murphy, she was referred to the Comprehensive Employment Opportunity (CEO) center for a transferable job skills assessment. The purpose of the work assessment was to assist Jim and Tamara in determining more specifically where her skill set, interests and values were in relationship to work. While Tamara was participating in the evaluation process, the CEO discovered she had all the right qualifications and skills to fill the Assistant Case Manager position they had available. The CEO offered her the case management position and she happily accepted. The position met her employment goal to utilize her training to help individuals with disabilities find and keep jobs. Tamara now has a caseload of approximately fifteen consumers with whom she works regarding job development and placement issues. She also facilitates a Job Club to prepare consumers for employment. Tamara finds her current job very satisfying, and says with a smile, "I can really relate to how these consumers feel." She is grateful for the opportunities and independence gained from her own experience with the MRC and is also thankful for being able to reach her own goals, because now she can help others to do the same.

In May of 2001, Corey and Tamara's separate success stories became one. They met as youngsters through United Cerebral Palsy sports teams and eventually fell in love and were married. They are now both employed and looking to buy a new house. MRC gave them a chance at happiness and they have done very well.


Vocational Rehabilitation Facts and Figures

Vocational Rehabilitation Program Outcomes Competitive Employment
Number of consumers competitively employed for more than 90 days3,861
Facility Based Employment
Extended Employment Program Goal Total
Number of consumers who received services1,047951
Number of consumers who were placed in employment4816
Number of employed consumers who received personal care assistance, maintaining employment2020
Integrated Independent Employment
Community Based Employment Programs Goal Total
Number of consumers served340484
Number of consumers placed in employment126180
Number of consumers who completed program100144
Number of consumers in extended services-142
Integrated Employment with Support
Supported Employment Program Goal Total
Number of consumers served110158
Number of consumers who completed program4444
Total Consumers placed/retained in employment 4,085

State Rehabilitation Council

The mission of the State Rehabilitation Council (SR/C) is to advise the Public Vocational Rehabilitation Services agency in the delivery of effective rehabilitation services which lead to employment for people with disabilities, and to advance the use of resources necessary to promote the independence of citizens with disabilities in Massachusetts. Members are appointed by and serve at the pleasure of the Governor. The membership reflects a representation of persons with disabilities and disability advocacy groups, current and former consumers of vocational rehabilitation and independent living services, people in business and industry, the medical profession, education and community rehabilitation programs. Members of the State Rehabilitation Council are volunteers who donate their time to fulfill the mission of the SR/C.

STATE REHABILITATION COUNCIL MEMBERS

MRC State Rehabilitation Council Appointees

  • Zary Amirhosseini, South Boston
  • Andrea Bader, Boston
  • John Beach, Hyannis
  • Janet Dale, Milford
  • William Doherty, Arlington
  • Yvonne Dunkle, Boston
  • Toby Fisher, Woburn
  • Manuel Gross, Florence
  • Brooke Heraty, Boston
  • Sandra Houghton, Boston
  • David Kaiser, Northboro
  • Betty J. King, Boston
  • Barbara Lybarger, Boston
  • William McCarriston, Boston
  • Kimberly McLaughlin, Canton
  • Oswald Mondejar, Brookline
  • Mark Murphy, Dartmouth
  • Angelica Sawyer, Cambridge
  • Patricia Sheely, Pittsfield
  • Antonia Torres, Holyoke

Ex-Officio Members

  • Denise Bastoni, Lowell
  • Kathleen Cardin, N. Westport
  • Owen Doonan, Duxbury
  • Suzanne Doswell, Pittsfield
  • Anne P. Guterman, West Newton
  • Inta Hall, Hingham
  • James Hanna, Roxbury
  • Stephen Holochuck, Brighton
  • Karen LaChapelle, Southampton
  • Kathy Mooney, Salem
  • Mary M. Moore, Salem
  • Maryann O'Toole, Boston
  • Ann Marie Paulson, Lakeville
  • Sonya Perduta, Spencer
  • Ventura Pereira, North Dartmouth
  • Carol Perlino, Lynn
  • Judith Poole, Watertown
  • Maria Rosa, Holyoke
  • Matlyn Starks, Boston
  • Hartmut Teuber, Allston
  • Hans Toegel, Boston
  • Francis Verville, Fall River
  • Barbara Walsh, Boston


MRC Customer Relations

The MRC has two staff persons working within the Commissioner's Office in the agency's Customer Relations Department. One of these staff members is a full-time Ombudsperson who serves as a customer liaison, primarily to address consumer concerns regarding the delivery of services, as well as to answer a variety of disability-related questions. People who typically contact the Ombudsperson include consumers, family members, advocates, legislators and their aides, or MRC staff. The Ombudsperson frequently provides information and referral services and assists callers to better understand the services offered by the MRC. If a complaint is brought forward, the Ombudsperson promptly reviews the matter and works with consumers and MRC staff to find a solution. If this type of intervention does not bring about resolution, a formal appeal and mediation process is also available to consumers, both handled by the agency's Appeals Coordinator.

The Ombudsperson assists consumers across all service programs and may be contacted by telephone at (617) 204-3600 or 1-800- 245-6543 (voice and TTY), through the agency website at www.mass.gov/mrc or by writing the MRC Administrative Office at 27 Wormwood Street, Suite 600, Boston, MA 02210-1616


Independent Living Program Overview

The Independent Living (IL) Program of the MRC was established in 1985 and offered programs such as Work Personal Care Assistance (PCA), Head Injury Services and Independent Living services. The philosophy underlying the provision of IL services holds that persons with disabilities have the right to control their own lives and access the same opportunities as other people without disabilities.

MRC's IL Programs have steadily grown along with the population of citizens with disabilities in the Commonwealth, expanding its operations to include Home Care Assistance, Supported Living, Turning 22 and Protective Service programs. Most recently, a number of programs have been developed to provide assistance with securing or adapting housing, such as the Home Modification Loan Program (see description, pg. 35) and the MassAccess Housing Registry, as well as providing for the technology needs of individuals with disabilities who have independent living goals through the Assistive Technology Program. While technology is often used to assist people with disabilities at work, it can also be used by people in their homes to access information via the Internet, conduct banking and shopping, as well as for general communication purposes.

Several IL programs have long waiting lists, such as the Statewide Head Injury Program (SHIP) and Adult Supported Living, which was established to coordinate services for adults with severe disabilities who have a cognitive, emotional or sensory impairment. The goal of all such supported living services is to assist individuals to live as independently as possible in the community, rather than in nursing homes. In fiscal year 2002, the MRC-IL programs collectively assisted 2,236 individuals to leave or avoid being placed in an institution or nursing home, thereby saving the Commonwealth an estimated $121 million.


A Smile Says It All

Carol makes her way through the door of Stephen's apartment for their weekly meeting while being greeted by his two dogs, a cat and Stephen's smiling face. The older dachshund barks playfully, demanding attention, while the other dog shyly hides behind his owner. Carol teases Stephen about how plump one of his dogs is; Stephen shakes his head and laughs.

Stephen Sault was forced to work very hard to wear the smile he sports today. One night in 1989, when leaving a bar, a vehicle struck him. The accident plunged Stephen into a coma for nearly three months and left him with permanent side effects. He squints his eyes and gestures to recall how he felt after waking up, demonstrating to Carol that everything seemed hazy and frightening. Stephen had sustained a traumatic brain injury (TBI), today still accompanied by seizures, left-side paralysis and nonfluent aphasia, meaning he is unable to speak or write words. Though he can functionally read, he struggles with the loss of his short-term memory.

Upon regaining consciousness, Stephen spent more than three months in the hospital and then one year receiving outpatient services at Braintree Hospital. He took part in a Cognitive Retraining Program and after a limited time, was referred to the Statewide Head Injury Program (SHIP) within the MRC.

The MRC-SHIP provides publicly funded services to people with a TBI to help support them, their families and the communities in which they live and work. At MRC, Joan Smith, a SHIP regional program coordinator, helped to develop an Individual Service Plan (ISP) for Stephen. The plan included a referral to the HealthSouth Head Injury Center (HIC) in Quincy for services, where Stephen learned many strategies to help him communicate and regain some self-sufficiency.

Lisa, the assistant director at the HIC, remembers expressing concern due to Stephen's inability to verbally communicate. Although the aphasia hinders Stephen from speaking words, he compensates by using voice inflection, facial expressions and gestures. It took Stephen from 1989 to 2001 to make enough progress to finally obtain a job, but after all of the individually tailored services he had received, he was ready. At that point he was assigned a caseworker, Carol, to help him with his day-to-day life.

Carol sits down with Stephen to talk about how his week was. She looks at his feet and notices a brand new pair of red and white shoes. "Where did you get those Stephen?" Carol inquires. Stephen makes a lively vacuuming sound accompanied by an arm motion signifying "work."

"Oh, someone at work picked them up for you?" Carol interprets.

Stephen nods and holds up his hand forming a two then a zero. " Wow, only twenty bucks?" she asks correctly guessing again. Stephen smiles excitedly and nods "yes." Stephen's outgoing personality and expressive nature make it easy to understand the messages he conveys. However, sometimes expressing thoughts about places and names proves to be difficult, so Stephen carries communication aids, such as a small book of pictures with colors, people, places and words that he keeps in his wallet.

Carol points to a picture of a young boy posted on the wall in the kitchen and asks, "Who is that?"

Stephen gestures, but Carol does not correctly guess this time. Instead of getting frustrated, Stephen opens his wallet and flips through his little book until he comes to the name of his sister.

"Oh, the picture is of your sister's son, your nephew." Carol has the right answer now and Stephen nods.

Through the HIC, the MRC-SHIP obtains case management services for Stephen. The HIC also collaborated with staff in the Statewide Employment Services (SES) and Vocational Rehabilitation (VR) programs at the MRC to help find Stephen a job. SES staff connected Stephen with Morgan Memorial, one of the provider agencies MRC contracts with to assist consumers with job development and placement. Morgan Memorial found Stephen a maintenance job at the Barnes Building in Boston and provided job coaching to help integrate him into the workplace. A job coach is often the essential element needed to adapt and train a person with a severe disability on the job. This allows the new worker to learn the job comfortably, at their own pace and without disruption at the workplace, in order for him or her to eventually gain an increasing amount of self-sufficiency in the job.

When you ask Stephen if he likes his work he excitedly replies "uh huh!" raising his eyebrows and nodding his head up and down. Stephen expresses an aversion to sitting around all day and boasts that his job makes him feel productive. Also, by rubbing his thumb across his four fingers and pointing to his wallet, he shows he's making his own money, which is obviously very important to him.

Not only does he earn a salary doing maintenance work, the Disability Determination Services (DDS) found him eligible to receive Supplemental Security Income (SSI). Finally, after years of living at home and being partially dependent on his mother, MRC's Independent Living housing programs made it possible for Stephen to move into his own apartment in November of 2001. His pets were even allowed to come along with him.

Stephen successfully holds down his job while remaining independent. His apartment is within walking distance of the supermarket and he uses public transportation or THE RIDE to get to work. In order to combat the short-term memory loss, Stephen has a sign posted in his kitchen to remind him how much money to save for the week and which bills to pay and when. He also has a thorough filing system for his bills, receipts, bank statements and money orders. He has strategies to make everyday tasks easier. For example, to write a shopping list he draws pictures of the items he needs. Every week Carol drops by and offers assistance, whether it is explaining the fine print on the phone bill or helping schedule an appointment to get his cat vaccinated.

Stephen flourishes in and has been embraced by his community. He frequents the grocery store, the bank and Dunkin' Donuts without trouble. Lisa, the Assistant IL Director of HIC, says "what amazes me most about Stephen is how functional he is in the community." If he encounters a stranger who has difficulty understanding his methods of communication, he pulls out a card from his wallet. This card explains Stephen's situation along with his methods of communication.

"It is wonderful to see the progress Stephen has made over the years," Joan Smith says. "Sometimes with individuals who have had a severe head injury, progress takes a long time and often, many people don't get out and work." But Stephen fought against the odds to redevelop his strengths to achieve a satisfying new life of his own. If you ask Stephen how life is, he lights up, spreads his palm face down low at his side and raises it higher to signify that life is getting better and better. While sitting in his kitchen chair he points around his apartment, makes the gesture meaning "work," then holds his fist to his heart.

Lisa believes that, while it may seem a rarity, Stephen is genuinely happy. Stephen does not need words to express the satisfaction he has gained from working and living on his own; the look on his face says it all.


We Know How It Feels - We Know What It's Like

"As people with disabilities, most of our staff were once consumers themselves and have first-hand experience with many of the issues we help our consumers with every day. We know how it feels to be unemployed, without decent housing, recipients of bad service, or going in the back doors of public buildings," says Pam Burkley, Director of the Cape Organization for the Rights of the Disabled (CORD), a private non-profit agency. Both Burkley and CORD are dedicated to the betterment of life for persons with disabilities on issues such as these.

CORD began as a small group of people meeting in an empty room at Cape Cod Hospital. Burkley became involved years later, after a car accident left her paralyzed. She muses about the situation now, saying, "It wasn't clear to me until 10 years later why this accident happened to me. I went to a meeting at Cape Cod Hospital." That meeting launched Burkley into the world of disability advocacy where she has been assisting herself and others for 20 years. With Burkley's recent promotion to Director of CORD, she is seeing years of advocacy paying off in a job she truly loves.

CORD has progressed along with Burkley. What was once a small group of people known as the "Project on Self Advocacy" has become CORD, a thriving human service organization, and Burkley, who was once a volunteer when there was no funding available, is now the director. Today, Burkley, her staff and all of CORD's programs are funded by state and federal independent living money.

CORD operates an Independent Living (IL) program and is one of a network of eleven IL Centers located across the state. CORD assists consumers by teaching and training them in ways in which they will benefit in the long run, rather than providing a quick fix. For example, instead of CORD handling a landlord problem for a consumer, they teach the consumer ways to deal with the problem on their own. The primary goal is twofold: to create increased opportunities for independence and to assist individuals with disabilities to achieve their maximum level of independent functioning within their families and communities.

Centers for Independent Living (CILs) which receive federal funds (Title VII) specifically designated to support IL programs must provide four core services to meet their mandated goals. The core services are to assist individuals with disabilities to achieve their self-identified goals through peer counseling, skills training, advocacy and information and referral services. IL Centers also offer other programs to meet the needs of their local constituency, including, but not limited to, housing referrals, communication assistance, support groups, transportation and health information.

One example of CIL service provision is illustrated by consumer Heather MacNeil's story. Heather referred herself to CORD in July 1998 after graduating from high school. Her developmental disability required that she receive specialized services in order to effectively get job training, live independently and learn about the community resources available to her. Her CORD Advocate, Jocelyn French, worked with Heather to assist her in securing SSI benefits and receive the supports and services she needed from a host of human service agencies.

Heather wanted to attend college, and after being referred to an MRC VR counselor she enrolled in Project Forward's eldercare training program at Cape Cod Community College. Although Heather was ultimately not successful in meeting the certification requirements required by law, she was encouraged to continue pursuing her independent living goals.

Heather was soon enrolled in a Department of Mental Retardation sponsored program providing assistance with cooking, money management and household chores, all skills in which mastery can lead to greater independence. In April of 2002, Heather courageously settled into her own subsidized apartment in Marion. She once again ventured out into the world of competitive employment, at times benefiting from a job coach provided by the MRC.

Heather has gained valuable real-world employment experience, managing to have a series of part-time jobs. With continued support and advocacy from CORD, Heather is still seeking just the right training program to assist her in getting and keeping a job for a longer period of time. Heather is quite motivated and will continue to try to become employed," states Jocelyn.

The staff at CORD remain a group of people with disabilities concerned with barriers to independence and have had many successes in their past. They have increased the number of ramps into doctors' offices, won greater access into the local community college, established designated parking spaces in private parking lots and improved access to decent health care. Early on, they saw themselves as advocates working on functional problems, rather than patients with medical problems.

More recently, CORD played a key role in shielding the state's Personal Care Assistance (PCA) Program from regulatory changes without the approval and sign-off of the Statewide Independent Living Council, the Governor's Advisory Commission on Disabilities and the Massachusetts Office on Disability. CORD also advocated for and won expanded MassHealth coverage to maintain PCA services for persons beyond the age of 65. A potential crisis was averted, thereby allowing older consumers to keep their PCA coverage and remain in their homes rather than being placed in nursing homes.

CORD is continuously looking for ways to meet the expanded housing needs of persons with disabilities. They have always been opposed to the clustering of persons with disabilities into segregated housing and have recently worked with Habitat for Humanity to include "visitability" into all their new home construction. CORD staff were also instrumental in obtaining HUD funding to construct 2 housing units for 6 people with disabilities in a mixed income neighborhood in Yarmouth.

Over the years, CORD has diligently worked to ensure that the voice of people with disabilities is heard when and where a decision being made will have an impact on their constituency.

Burkley says her recent promotion to Director has greatly increased her opportunity to promote CORD. Even the interview process excited her, as she was able to articulate what she was currently doing and where she wants to see CORD in the future. Burkley says of her work, "I don't necessarily like having a disability but my injury led me to this great career and brought out the best in me. So in an odd sort of way, becoming disabled was a good thing for me. Mind you, I'd rather be walking on the beach, but then again, I would have missed all this."


Transitioning Young Adults With Disabilities

Frank Benevides, Chapter 688 Coordinator, has worked for the MRC since 1989. Chapter 688 is a law providing for a two year transitional process for young adults with disabilities who will lose their entitlement to special education upon graduation or reaching the age of 22. This law serves as a bridge from the school system into the world of adult human services and creates a single point of entry by developing an Individual Transition Plan (ITP) for every student with a severe disability. Those who are found eligible must be in need of continuing services and unable to work 20 or more hours per week in competitive, non-sheltered or non-supported employment. Frank works diligently to ensure students in transition do not "fall between the cracks" and receive the supports they need to live and work in the community.

Frank also serves on the state's Transitional Advisory Committee (TAC), comprised of representatives from agencies in the Executive Office of Health & Human Services (EOHHS). The TAC makes assessments regarding the needs of eligible students and recommends which agencies would best be able to meet those needs. They also assign all clients to a transitional agency which establishes their eligibility, assists with referrals to one or more appropriate agencies and develops the ITP. Involved and appropriate human service agency staff, school system personnel, family members and the consumer or youth with the disability, are all encouraged to participate in the ITP process.

The case of Mr. Chris Menard is a shining example of the success a consumer might expect from the MRC Chapter 688 transition program. Chris has multiple disabilities, most of which present significant challenges in his everyday life. These challenges make him eligible for residential services and special education supports, such as academic programs specifically tailored toward his particular needs. Shortly before Chris reached his 22nd birthday, his situation was reviewed by the TAC and assigned to the EOHHS agencies which could best provide the services as required on his ITP, one of which was the MRC Vocational Rehabilitation Program. The MRC-VR Program was deemed responsible for his day program, pre-employment and transportation services, while the Department of Mental Retardation was made responsible for case management and residential services. However, the MRC Fall River VR Office believed Chris' unique barriers to employment made him an unsuitable candidate for traditional vocational rehabilitation services. At that time, Chris required intensive ongoing services beyond what VR typically provides. His previous behavior patterns and inability to hold a job without long-term supports made him an ideal candidate for the MRC Statewide Employment Services (SES) program.

Frank and his team decided that Chris would benefit from the experience the MRC-SES Program has dealing with challenging individuals who need extensive supports to gain employment and the long-term supports needed to sustain employment.

His case was brought to the attention of Jim Fratolillo, an active member of the TAC and Director of the MRC-SES Program, and Kim Lapine, Program Coordinator for SES, who also assisted with Chris' transition. Both individuals met with him to determine his eligibility for services and, after careful review of all issues, Chris was found to be an appropriate candidate. Kim became his case manager and immediately began searching for potential employment and other services that would benefit Chris.

In just one short year, Chris has made giant strides toward independence and a stable career. He landed a full-time job as a machine operator finishing bolts at the Robbins Manufacturing Company in Fall River, earning $8.00 an hour. He has formed many friendships there that now extend beyond the workplace.

Until now, Chris had not been successful at retaining employment and feels that his greatest accomplishment has been keeping this job.

Soon, Chris will be moving to a new group home that will bring him closer to his family. Hard work, a good job match, strong team support and stable residential services have been the foundations of his success.

With the strong commitment of the MRC staff and other state agencies dedicated to community partnerships, the public can anticipate many more success stories like that of Chris Menard.


Giving Something Back

Margaret Paradis is an inspiration to the people who know her and to anyone living with multiple sclerosis (MS). Margaret has faced this unpredictable disease for twelve years, living her life the way she always has - with courage and fortitude.

Despite its symptoms, multiple sclerosis has not stopped Margaret from having a full life. MS is a disease that affects the central nervous system. As a result, nerve conduction is impaired and one's organs may not receive the information they need to function normally. In Margaret's case, the disease has resulted in reduced muscle tone, unsteadiness, a decreased ability to stand, some memory loss and reduced flexibility.

The MRC Home Care Assistance Program (HCAP) provides homemaker services to eligible adults with disabilities who are functionally limited in meeting their own nutritional and environmental needs. The goal of the MRC-HCAP is to enhance the independence of people with disabilities and prevent unnecessary hospitalization or institutionalization by providing direct assistance with homemaking tasks.

Consumers like Margaret are screened for preliminary eligibility, financial need and medical conditions warranting home care assistance and are provided with an in-home assessment conducted by a nurse evaluator. If eligible for the program, a case manager is assigned to the consumer who contracts with a home care agency and sets up a weekly schedule for services. A review of the consumer's needs is conducted every 18 months to reassess eligibility, quality of care and the number of service hours still required.

Roberta Medal has been Margaret's MRC-HCAP Case Manager since 1993. Her responsibility is to assess Margaret's eligibility, coordinate service provision in conjunction with home care agencies and assist by offering information and referrals to advance her independent living goals. Margaret and Roberta have formed a very special and unique relationship, one that is built on trust and acceptance and one they believe will continue to thrive and grow. It is common practice for HCAP case managers to become closely involved in their consumers' plights and essentially provide emotional support and encouragement to them in their efforts to live independently.

While many people with MS eventually require 24- hour care and live in specialized facilities, Margaret maintains her autonomy, living in her own apartment, thanks to the efforts of people like Roberta. To maintain her independence, Margaret receives twice weekly services from the MRC-HCAP contractor and daily visits from the Visiting Nurse Association (VNA). The MRC-HCAP provides Margaret with 4 hours of assistance each week to assist her in accomplishing basic homemaking tasks which she cannot perform herself, such as grocery shopping, cleaning, laundry, vacuuming, dish washing and meal preparation.

Margaret's attempts to live independently and remain active in the community show in her volunteer efforts at the New Pond Respite Center in Easton. This facility provides day care and socialization opportunities for elderly people. Twice a week Margaret spends the day talking, socializing and playing bingo with program participants. She has formed strong relationships with everyone at New Pond, staff and consumers alike, and plans to continue her volunteer work as long as she is able.

In addition to her volunteer work, Margaret spends many hours pursuing her passion for knitting and crocheting. Since the age of eighteen, Margaret has been making clothes for special people in her life and recently began knitting for charity. She takes great pleasure in helping others despite her own medical problems. Margaret refuses to let MS take over her life and the things she loves most.

The support of people like Roberta Medal and the MRC Home Care Assistance Program has allowed Margaret to continue to live a rewarding and full life. By assisting Margaret with her most basic daily needs, the MRC-HCAP has allowed her to maintain her independence and to assist others in need in her community.


Home Modification Loan Program

The MRC Home Modification Loan Program (HMLP) provides no-and low-interest loans, including deferred payment loans, to low and moderate income households in which at least one member has a disability and requires a home modification. Modifications can include ramps, lifts, modifications to bathrooms and other types of access adaptations. MRC sponsors the program which is administered on the community level by the Community Economic Development Assistance Corporation (CEDAC), a quasi-public agency, through six local non-profit agencies.

Since the HMLP began in 1999, 328 Massachusetts households have taken advantage of the program. Loans of $1,000 to $25,000 are available, with most loans averaging approximately $21,248. To date, the HMLP has approved more than $9.2 million in loans for modifications ranging from elevators and wheelchair accessible bathrooms and kitchens, to grab bars and visual safety alarm systems.

The state loan program has helped thousands of residents by improving the quality of life for children and adults with disabilities and saving on the costs of institutionalization.

The MRC is grateful to CEDAC and the HMLP staff for making this program a stellar example of a successful public-private-state partnership.


Independent Living Facts and Figures

Service Delivery Report FY '02
Protective Services Total
Number of consumers who received services135
Number of new service plans139
Number of consumers provided paid services113
Number of investigations278
$ Expended$392,281
Head Injury Services
Number of consumers who received services770
Number of new applicants288
Number of services purchased for consumers724
$ Expended$10,300,000
Home Care Services
Number of consumers who received services1,532
Number of new cases opened507
Number of hours of services provided245,096
Expended$5,616,185
Turning 22 Services
Number of consumers who received services69
Number of consumers in Supported Living services44
Number of new Individual Transition Plans developed10
Number of new intakes11
$ Expended$1,739,513
Supported Living Services
Number of consumers who received services91
Number of consumers on waiting list32
$ Expended$707,412
Housing Registry
Number of new listings112
Number of vacancies541
Number of housing calls to Independent Living Centers26,000
$ Expended$93,020
Assistive Technology Program
Number of consumers who received services637
Number of consumers on waiting list646
$ Expended$573,100
IL Center Services
Number of consumers who received services12,000
Number of Information and Referral calls27,725
$ Expended$4,407,246
TOTAL IL CONSUMERS SERVED 29,804


Disability Determination Services Overview

Every state in the USA operates a Disability Determination Services (DDS) program, handling all Supplemental Security Income and Social Security Disability Insurance applications on behalf of the Social Security Administration (SSA). Last year, the Massachusetts DDS processed more than 82,000 claims. SSA measures the effectiveness of all state DDS agencies on an annual basis. Over the years, the MRC-DDS has been recognized with numerous awards for its high quality and efficient performance. The SSA Northeast Regional Office has come to depend on the expertise of the Massachusetts DDS, sending them many of the claims from other New England states, including RI, NH and CT, having difficulty keeping up with the heavy workload of case processing.

This fiscal year, the MRCDDS won 3 prestigious SSA awards in recognition of its innovation and teamwork, its superior performance in providing services to persons with disabilities and for assisting other DDS agencies in their region (see story, pg.38). The Commonwealth reaps tremendous benefits as a direct result of the work carried out at the DDS. Not only do some of the state's most impoverished and disadvantaged citizens get the critical support they need, but Massachusetts also benefits as these claimants receive and return to the local economy $202 million in benefits resulting from claims approved by the SSA in a given year.

The Disability Determination Services Advisory Committee was formally established in the early 1980's. It functions as a communication bridge between the DDS staff and consumers of its services, the community of persons with disabilities and their advocates.

DDS ADVISORY COMMITTEE MEMBERS NAME and AFFILIATION

  • Sarah Anderson, Greater Boston Legal Services
  • Chris Czernik, Lynn Emergency Housing
  • Rose Dixon, Cambridge
  • Taramattie Doucet, Greater Boston Legal Services
  • Judith Grunba, Concord
  • Gail Havelick, Department of Public Health
  • Ben & Lillian Haynes, Brookline
  • Emily Herzig, Neighborhood Legal Services, Lynn
  • Betty King, Boston
  • Ruth Lemay, Worcester
  • Kathy Mooney, Salem
  • Ann Marie Paulson, Lakeville
  • Barbara Siegel, Community Legal Services, Cambridge
  • Joanne Spencer, Brockton
  • Matlyn Starks, Boston
  • Sandy Tranfaglia, Winthrop
  • Francis Verville, Fall River


DDS Awards

The Massachusetts DDS is recognized as one of the best performing agencies of its kind in the nation. They have continued their outstanding work performance again this year, winning three awards and maintaining the top ranking among their counterparts throughout the nation.

In April 2002, Brian Miles, Director of Quality Assurance and Professional Relations in the Worcester DDS Office, received the Social Security Commissioner's Citation for Exemplary Performance in Accuracy, Timeliness, Productivity and Providing Exceptional Service to Massachusetts Citizens with Disabilities. This is the highest Social Security Administration (SSA) honor given and is an opportunity to recognize DDS employees who have exhibited the utmost in professionalism in the conduct of their assignments. Brian's professionalism has translated into improved public service to, and on behalf of, individuals with disabilities. He has always demonstrated outstanding knowledge of the disability program and has been a contributor in terms of both novel ideas and their implementation. His work in quality assurance has been outstanding.

In May 2002, the management team of Kasper Goshgarian, Barbara Kinney and John Reilly received the Regional Commissioner's Citation Group Award from the Social Security Administration, presented in recognition of their outstanding management in leading the Massachusetts DDS to the top of the nation's ranking of DDS agencies. This was accomplished while lending assistance to the SSA Regional Office and DDS agencies in other New England states as well. The Massachusetts DDS is acknowledged by SSA as an innovative agency and with this award recognized their superb management team who has provided excellent services not only for the citizens of Massachusetts, but to the larger SSA regional community as well.

Also in May 2002, the Massachusetts DDS received the Greater Boston Federal Executive Board's Excellence in Government Team Award for Creativity and Innovation. The Massachusetts DDS is part of a team which includes all DDS agencies in New England and the SSA Regional Office. This team was recognized for their outstanding work in serving citizens with disabilities in the states of Massachusetts, Connecticut, Maine, New Hampshire, Rhode Island and Vermont. The team of the six New England DDS agencies far exceeded all critical performance measures and are national leaders in disability claims processing. Congratulations to the MRC-DDS.


Helping those in need in Massachusetts

It's true the people who work at the Massachusetts Disability Determination Services (DDS) Program have a job to do like all other DDS staff across the country. They all have the same mandate - to process SSI and SSDI claims according to strict guidelines clearly delineated by the Social Security Administration (SSA) - their operations completely funded by this federal agency. But it's also true that if you look a little further, beyond the rows of cubicles, and dig a little deeper, beneath the mounds of paperwork, you will find employees performing little miracles every day. Some of these staff members were national pioneers in handling the special claims needed by individuals with HIV while others blazed the trail in developing specialty units to administer the claims of people who were homeless. A large number of these employees are among those who brought their DDS to the rank of #1 in the nation for the high percentage of claims allowed by the SSA.

Most are simply the unsung heroes of tens of thousands of Massachusetts residents with disabilities who find themselves suddenly disabled and/or unable to support themselves or their families. A few of these everyday heroes are among the dozens of medical consultants who work with the DDS Vocational Disability Examiners, helping to validate the applications submitted on behalf of Social Security claimants. One such consultant is Sita Ram Upadhyay, M.D., fondly known as Dr. Ram in the DDS Worcester office. His specialty is Internal Medicine, and aside from his regular duties, helps to organize local homeless efforts and has also arranged health fairs for homeless individuals in Dorchester, Roxbury and Worcester. On top of this, he can be found working tirelessly with international relief organizations.

"From my earliest exposure to Hindu Scripture, I embraced the belief that the world's inhabitants are part of your family and no one should experience suffering due to a lack of food or health care" remembers Dr. Ram. "I was led to a career in medicine when, as a young medical student, I worked in the Indian relief camps where thousands of flood victims, many afflicted with cholera, cried out for food, shelter and medicine. I witnessed the miracles bestowed by Mother Teresa and her staff with their exemplary commitments to the values of faith, family and dignity. The endurance of the human spirit remains my inspiration," he explains.

Dr. Ram received the Gregory Schipani Humanitarian Award from the Massachusetts DDS in 1995.

His volunteer efforts have also been recognized by other organizations, receiving awards from the Worcester Medical Society in 1996, the Massachusetts Medical Society in 1997 and from Harvard Pilgrim Health Care in 1998.

Another consulting physician is Romany Girgis, also a medical consultant to the DDS Worcester office and specialist in Internal Medicine. Like Dr. Ram, his dedication does not stop at the office door. More than five years ago, dismayed over the plight of the patients he met who could not afford to buy the medications they had been prescribed or who had no medical insurance because they had lost their job, Dr. Girgis began donating his services at the Worcester Evening Free Medical Service Program Clinic. Started by Dr. Paul L. Hart in the basement of the Epworth Methodist Church, the Clinic has grown so much that eye and ear services are offered in another nearby church. Working one night per week, Dr. Girgis has not missed a single night since he began volunteering there, some 60 months ago. It is in this same spirit with which Dr. Girgis works with the claimants he sees from DDS. His role is to examine each applicant referred to him and ensure that their diagnosis of one or more disabilities is accurate. More than just a physician validating their disability claim, he acts as an information specialist as well, freely sharing his time and knowledge of local resources. Many applicants get referred to the Free Clinic, open to anyone without medical insurance, which operates every Monday evening from 6:00 - 8:00 p.m.

Although hidden from the public eye, there are two unsung heroines who make all of these good works possible. They are Margaret O'Connor, Director of Medical Contract Management and Professional Relations, a DDS-Boston employee for 27 years, and Patricia Cody, Medical Relations Officer, a DDS Worcester employee for 18 years. As the Medical Relations Director, Margaret has responsibility for approximately 85 in-house medical, psychiatric and psychological consultants like Dr. Ram and Dr. Girgis. Together, both Patricia and Margaret oversee more than 600 community-based medical providers who provide contracted services. This includes recruiting and interviewing prospective consultants, as well as credentialing and providing educational orientation for those candidates who are accepted. In their roles working with the public, Margaret and Patricia conduct intensive educational outreach to the Massachusetts medical community in an effort to solicit physicians and psychologists for consultative examinations. Given the amount of paperwork and services required, this is a monumental task, as they are also responsible for the training, contracting and management of the services provided by these consultants.

An important part of their job is making a special effort to recruit and retain a diverse pool of medical providers reflective of the wider community served by the DDS, particularly those who are bilingual, in order to provide the highest health care quality and most comprehensive services possible. Margaret visits hospitals, clinics and other facilities in Eastern Massachusetts in an attempt to explain the value of physician participation to both patients and the disability program, while Patricia performs the same duties in the Western part of the state. They must also respond to phone calls and letters from physicians and hospitals regarding their perceived inadequacies of the DDS fee schedule for records they are required to submit.

Of equal if not greater importance, both Margaret and Patricia oversee the review and investigation of all customer complaints regarding their examinations and ultimately decide the appropriate action taken with providers, if any. This could include remediation, termination and, as necessary, reporting misconduct to appropriate state and federal authorities. Also no small feat, they review and manage the investigation of all legal requests for sensitive medical information such as requests under the Freedom of Information Act, and Margaret must handle subpoenas and depositions as well.

Finally, Patricia and Margaret work with other government agencies, both state and federal, to "troubleshoot" and discuss pertinent medical issues and work with the broader claimant and advocacy community. A key member of each regional DDS management team, Margaret and Patricia continue to assist the agency in performing little miracles for citizens with disabilities in Massachusetts every day.


DDS Facts and Figures

DDS FACTS AND FIGURES
Total Receipt of Cases82,860
Total Disposition of Cases82,806
Total Budget$31,925,229
Cost Per Case$385
Continuing Disability Review (CDR) Receipts21,416
Continuing Disability Review (CDR) Dispositions21,411
Consultative Examinations Purchased24,923
Consultative Examination Rate30.1%
Medical Evidence of Record Purchased63,923
Medical Evidence of Record Rate77.2%
Total Medical Costs$6,836,089
Accuracy of Decisions as Measured by SSA94.3%
DEMOGRAPHICS OF POPULATION
Total Population (Massachusetts)6,349,097
Initial Claims Filed46,773
% Allowed44.9%
Persons Below Poverty10.7%
Low Income Population31%

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Mitt Romney, Governor
Kerry Healey, Lieutenant Governor
Ronald Preston, Secretary, Executive Office of Health and Human Services
Elmer C. Bartels, Commissioner of Rehabilitation

This information provided by the Massachusetts Rehabilitation Commission.