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 MRC: the Vocational Rehabilitation Services Program, the Community Services Program and the Disability Determination Services Program. Massachusetts Rehabilitation Commission Vision
Executive Management Team
ELMER C. BARTELS, Commissioner of Rehabilitation
JOHN A. CHAPPELL, JR., Deputy Commissioner, Community Services
CLAIRE T. GHILONI, Deputy Commissioner, Administration & Finance
KASPER M. GOSHGARIAN, Deputy Commissioner, Vocational Rehabilitation
Services and Disability Determination Services
JANNA ZWERNER, Chief of Staff
TABLE OF CONTENTS
Vocational Rehabilitation (VR)
- Vocational Rehabilitation Services Program Overview
- Careers In The Arts
- Cultural Understanding Promotes VR Success
- Attaining Self Employment
- Forever Learning
- The Benefits of Assistive Technology
- Employment Retention
- State Rehabilitation Council
- VR & ES Facts And Figures
Community Service (CS)
- Community Services Program Overview
- Youth In Transition
- Overcoming Abuse
- Nursing Home Transition
- From Head Injury To Homelessness... And Back
- Transportation Initiatives
- CS Facts And Figures
Disability Determination Services (DDS)
- Disability Determination Services Program Overview
- Building Understanding Through Communication
- Addressing Homelessness
- DDS Facts And Figures
Antonio R. Harris, Photographer
A Message from Commissioner Bartels
I am pleased to be able to share with you the Massachusetts Rehabilitation Commission (MRC) Annual Report for Fiscal Year 2003. We experienced many changes this past year and are appreciative of the support we have received to make Massachusetts a better place to live and work for all of us, particularly for individuals with disabilities.
Within the pages of this Annual Report, you will read the success stories of just a handful of our constituents, including consumers, staff, employers and community providers.
As in the past few years, this year the Annual Report reflects the growing role that our partnerships play in assisting people with disabilities to live independently and keep or find a job. By working collaboratively, we serve many people in a more effective manner than we otherwise could.
For example, the business community continued to assist us with our mission and advance our cause in numerous ways. This accomplishment took place 2,710 times in Fiscal Year '03, with the hiring of skilled consumers with disabilities ready and able to fill a job an employer needed to have done.
Without such dedication and partnerships with the employer community, keeping the creeping unemployment rate at bay would not be possible.
The MRC strives to acknowledge its employer partners by nominating businesses for the Massachusetts Governor's Exemplary Employer Award. These companies work with agency staff and set a positive example by embracing the practice of hiring qualified persons with disabilities. This honor is awarded by the Governor every year to employers who hire persons with disabilities, provide these employees with competitive wages, benefits and an opportunity for advancement in their careers. Last year, seven MRC employer partners who were nominated by the MRC won these coveted awards.
Central New England Health Alliance in Leominster, The Cintas Corporation of Pittsfield, Clinical Science Laboratory, Inc. in Mansfield, Old Country Buffet of Pittsfield, Price Chopper Supermarkets in Pittsfield, UnumProvident Corporation in Worcester and Willow Laboratories & Medical Center of Lynn, are 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 all sectors of the Massachusetts
Every 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.
As always, the Massachusetts disability community has been our constant partner and continues to work closely with us. While the MRC exists to provide services to this multifaceted group, their collaboration and constructive criticism has also served this agency very well, assisting us in shaping our programs and refining our services over the years in the most meaningful ways.
It has been an honor to serve the Commonwealth and the disability community in my capacity as Commissioner. I am proud of each one of our customers and the MRC staff who made a difference in their lives.
Vocational Rehabilitation Services Program Overview
The Public Vocational Rehabilitation (VR) 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. The 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 the employment barriers facing people with disabilities.
Over the years, the VRS Program has vastly expanded its services to meet the needs of people with the most significant 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, barriers to employment encountered by persons with disabilities have improved, but still remain. Nonetheless, in FY 2003, the MRC-VRS program helped more than 2,700 people with disabilities get productive jobs, collectively earning approximately $50M in their first year of employment. With the average wage of approximately $11 per hour, these motivated employees paid $10M in taxes to Massachusetts and the Federal Treasuries.
Federal funding continues to be a major barrier in placing all eligible consumers who want to work into competitive employment. The MRC-VRS Program continues to operate under an Order of Selection system where services are provided to those deemed the most significantly disabled (MSD). In FY 2002, the VRS Program operated under an indefinite Wait List. Throughout FY 2003, the Wait List was released on a regular basis and FY 2003 began and will end with a rolling Wait List of only four months. This has greatly increased the number of new consumers entering our service delivery system and will result in more people with disabilities being able to enter employment in the months ahead.
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 VRS Program has a very active State Rehabilitation Council. This past year, approximately 20 gubernatorial appointees served on the State Rehabilitation Council and provided oversight and guidance to staff working in all areas of the Vocational Rehabilitation Services Program.
CAREERS IN THE ARTS BY PAUL KAHN
Keith Jones has always managed to shine a little brighter than most. At the age of 8 months, Keith was diagnosed with cerebral palsy. This affected his speech and motor function. Essentially, he would never walk or talk quite like most other people. But being an outspoken, rambunctious child, he was inspired by the fact that his family never allowed him to feel "different." This has carried throughout his life. Always a lover of art and music, he began writing songs at the age of seven, with the help of his grandmother.
Keith's association with the Massachusetts Rehabilitation Commission goes back a long way, back to 1987 when he applied for services at the Roxbury Vocational Rehabilitation Services Office. One of the services Keith received was assistance from the MRC in attaining a college education, which he achieved in 1994 when he graduated with a Bachelor's Degree in Sociology with a minor in African American Studies. Keith remembers his VR counselor, Bob MacDonald, with deep respect. "He was a great man. Whenever there was a problem I'd call him, and he'd help a lot."
Attending college was a turning point for Keith, a time of awakening. "That's when I became an activist. I became conscious of what went on in the world and how it affects people with disabilities," he explained. Although he sees hurdles, he also sees that we are on the road toward people accepting others for who they are, not for perceived limitations.
For Keith, art and creative talents are the vehicle. Keith's passion is using the arts to change attitudes about disability. "I want to raise public consciousness about people with disabilities," he says. "I want to put this issue on a par with discussions about education, health care and civil rights." And, he believes that an integral part of this process is increasing cultural access for the disability community."
Pursuing that vision after college, Keith worked for 21/2 years at Very Special Arts (VSA) of Massachusetts as coordinator of the Boston ArtReach Initiative. ArtReach tried to bridge the gap between the cultural community and the disability community by educating cultural organizations about accessibility and helping people with disabilities to get access to the arts by acquiring free or discounted admission tickets to events. Keith is gratified by the changes that have come about as a result of this project. "Cultural access is much better than it used to be." But, he cautions, there are still great strides that could and should be made. "Cultural organizations have to be creative in their programming, which means things like having American Sign Language interpretation for the Deaf, as well as other forms of accessible programming. It also means having events in buildings that people with mobility impairments can enter. This would help to dispel the myth many businesses have that it is cost prohibitive to make themselves accessible. Although the ADA has brought many changes, there is still much work to be done. Money is limited and sometimes people miss the broader benefits to a society that is open and accessible to all."
In 2000, he co-chaired the MRC State Rehabilitation Council Task Force for Artists with Disabilities. He wanted to present art as a viable vocation, a viable industry and a right of free choice by MRC consumers. When Keith addressed the Council at one of their meetings, it was an electric moment, and the SRC unanimously accepted the Artists with Disabilities Task Force as an exclusive advisory group championing the right to choose art as a vocation.
In the economic slow-down, Keith was not immune to budget crises facing many small and mid-sized non-profits. As a result, Keith was laid off from his Program Coordinator's position. Rather than allowing this to be a setback, he viewed it as a blessing in disguise. This situation now afforded him the possibility to "live da dream" or, die without really chasing his passion.
Now, at age 33, Keith is a professional hip hop musician whose dedication to social change is part of the rhythm of his being. While making a living from his music still remains an ideal, Keith, like many artists, has learned to diversify. Since having been laid off from VSA, he has started his own business, Soul Touchin' Experiences (www.dasoultoucha. com), consulting in the areas of disability awareness and outreach to people of color who have disabilities. He also produces a wide variety of music, including classical and jazz.
Keith also sits on the boards of Partners for Youth with Disabilities and No Limits Media. "The reason people work, other than just to survive and sustain their families, is to be able to relax and entertain themselves. When you want to entertain yourself, you go to a movie, a play or a museum. But when you can't do that, because you just physically can't get in the door, your world becomes restricted. You're not independent, and that's not healthy. Cultural access gives you more independence. It helps you feel like you're part of the community. That's why it's important," he stated.
Today, Keith is working on developing his own one-man show involving multimedia and hip-hop. The show is still in the planning stages, but whatever it turns out to be, it's sure to be provocative. It's sure to challenge people's assumptions about disability and race. Because that's what Keith Jones is all about.
Paul Kahn, M. Ed., has spent more than 20 years as a writer, psychological counselor and disability rights advocate. He has written or co- authored six books and published more than 20 articles in national periodicals. The Kennedy Center for the Performing Arts, VSA Arts of Massachusetts and the Disability Law Center are among the organizations for which he has edited publications. His plays have been produced in both Boston and Maine. A recipient of a fellowship from the Christopher Reeve Paralysis Foundation for a residency at the Vermont Studio Center, he has also been honored with professional development grants from the Massachusetts and Newton Cultural Councils, a Personal Achievement Award from the Muscular Dystrophy Association, a Making A Difference Award from the Understanding Handicaps Program of Newton and an Alumni Award for Outstanding Achievement in the Arts and Humanities from Boston University.
Mr. Kahn is a former consumer of the Massachusetts Rehabilitation Commission, which, during his adult life, has assisted him with college tuition, vehicle modifications, computer equipment and training to support his career in writing. Earlier this year, the MRC awarded him a Certificate of Appreciation for his work as an advocate of independent living for people with disabilities.
CULTURAL UNDERSTANDING PROMOTES VR SUCCESS
JOE FERNANDEZ, BILINGUAL VR COUNSELOR
Patricia Resendes is just one of many MRC consumers who received multicultural services from a cadre of bilingual Qualified Vocational Rehabilitation Counselors. When Patricia graduated from high school, her transition into adult disability services was guided by Joe Fernandes, a bilingual counselor in the Fall River Vocational Rehabilitation (VR) office. Joe is an active member of the MRC-VR bilingual counseling team and works with other bilingual counseling specialists to resolve issues inherent to consumers and their families whose primary language is not English.
Patricia's parents, who only speak Portuguese, felt uneasy about accepting help from a government agency. Being protective of their child, Joe first had to build a trusting relationship with Patricia's parents in order for her to benefit from his vocational expertise. A seasoned VR counselor who speaks English and Portuguese, Joe is well aware of the cultural values and concerns of the Portuguese community of which he is a part. He was able to help the Resendes family clearly understand how the MRC would assist them and their daughter in making sound rehabilitation decisions.
Born with cerebral palsy, Patricia was limited in the use of both her left arm and leg. She was found eligible for MRC services under the Chapter 680/Turning 22 program, which provides transitional planning services for students with disabilities who require such services in order to transition to the adult community and/or vocational support services upon graduation from high school. Joe began the rehabilitation process by assessing Patricia's career interests, skills and abilities so together they might consider her vocational options. Did she want to go to work or attend college? What types of careers interested her? Patricia had expressed an interest in getting a job and knew she liked children, so she thought she'd enjoy working in the childcare industry. However, after a few counseling sessions with Joe, she soon realized there was a world of options open to her, one of which was working in the field of office management/computer technology.
Patricia and Joe developed a plan identifying the services and training needed to reach her goal of employment. After an evaluation to ensure her disability would not prevent her from being able to work on computers, she began taking classes at Computer Training Specialists in Fall River. After completing the course, Joe saw a change in Patricia. The quiet, shy, young woman he had first met was opening up more and more each day. She seemed more outgoing, more confident, and often had a smile on her face where previously there had been a worried frown. The skills she learned at the computer training program boosted her confidence in her abilities as well, enough to pursue her employment goal.
To facilitate Patricia's job search, Joe introduced her to Jeanne Tinkham, the Job Placement Specialist in the Fall River VR Office. Jeanne worked closely with Patricia to write a resume, hone her interviewing skills and develop a process to identify jobs for which she was qualified. Jeanne was able to negotiate a temporary secretarial position for Patricia at the local Social Security Administration (SSA) office. Without a proven track record of holding down a job and SSA's slow down of hiring new staff, they offered Patricia a 12-month temporary position. If she was successful on the job and the economy improved, allowing them to hire permanent employees, they agreed to consider hiring her at some point in the future. Because of Jeanne's close relationship with the SSA office, the SSA manager was willing to hire a job candidate with no prior experience. Thus, Patricia landed her first job as an Administrative Clerk. Her duties included filing, data entry, sorting mail and performing other office tasks and her supervisor was more than pleased with her performance.
As Patricia's world opened up, she decided to increase her independence by obtaining a driver's license. Joe arranged for Amaral's Driving School of New Bedford to provide ten driving lessons to Patricia, even negotiating with them to go to Fall River to teach her. Receiving her official Mass. driver's license was a huge step toward independence. Instead of relying on family and friends for rides to work or to run errands, Patricia was able to drive the family car to perform these activities on her own. Since public transportation systems where Patricia lived were not as accessible as in a more urban community such as Boston, Patricia realized how important it was to have a vehicle to access resources in her community or get back and forth from her job. Without this freedom, many people with disabilities remain isolated in their home and community.
As her parents continued to see impressive results, their attitude toward the MRC became more positive. Patricia was more outgoing and didn't shy away from new experiences as she had in the past. These developments in her personality were important not only for her social life, but for her employment goals as well.
Ultimately, her temporary position with the SSA ended. Social Security was still unable to hire permanent employees but informed Patricia and Jeanne that when hiring began again, they would be eager to have Patricia back.
Patricia began a new job search. A more outgoing personality helped Patricia perform well during interviews but the job market appeared bleak. Limiting her prospects even further was the fact that although Patricia could drive, she did not own a car and had to look for a position close to home. A new job goal of Child Care Attendant was developed with Jeanne. With Jeanne searching the community and drawing on her employer contacts, she was able to find a position at a local daycare center. Patricia worked successfully for approximately 7 months before being laid off due to a drop in revenues at the center.
Patricia is currently looking for another job with Jeanne's assistance. Social Security is still not hiring, but continues their interest in Patricia. Jeanne remains in contact with them and looks forward to the day they will again be hiring.
Although we would like to see Patricia employed by the close of this story, it's not to be, yet. However, her job prospects for an office manager or daycare provider position are much better than they were previously. She is now armed with current job skills and a growing work history with excellent references from her former employers. Jeanne says she knows there is another job for Patricia right around the next corner. With the both of them working on this goal - one will surely show up soon.
ARMEN GARABEDIAN, CONSUMER ENTREPRENEUR
Seascape Landscaping seems a fitting title for a landscaping business located on Cape Cod. But there is much more to Seascape than a clever name. This small business began in the spring of 2002 as a result of one very determined man's dream to become self-employed despite numerous challenges. For Armen Garabedian, Seascape is not just another small business; it is a tangible measure of the hard work and success he has toiled for on his long road to greater independence.
At 9 years of age, a car struck Armen causing a traumatic head injury. He had a loss of consciousness for almost two hours. After this injury, he suffered from constant headaches. Armen eventually recovered and as an adult had worked at many different jobs using a variety of talents. From carpenter and furniture maker, to arborist and mechanic, his many skills were a source of pride and essential to his identity. Then, in 1989 while cutting down a tree, a branch snapped and pierced his skull. He lay unconscious in the woods for eight hours. Since this second brain injury, Armen has been plagued with severe headaches, back pain, memory loss and depression. He also has dysarthria, making his speech difficult to understand. His headaches are so debilitating that he is often bedridden for days at a time. Although on medication and seeing a variety of specialists, it looks like Armen will have to live with these pains for the rest of his life.
After his second head injury, Armen's options for continuing to work at the particular jobs he loved seemed to come to an end and it was difficult for him to consider any alternatives. It appeared his talents would be wasted unless he could work in a skilled labor position as he had in the past. He shared this with his doctor from the Rehabilitation Hospital of the Cape & Islands, who contacted Community Support Associates (CSA) about Armen. CSA in turn contacted Angela Neal, Program Specialist at the MRC Statewide Employment Services (SES) Department, who reviewed Armen's case, assessing his strengths and weaknesses in regard to returning to work. Armen was found eligible and then enrolled in the MRC Community Based Employment Services (CBES) Program which allows consumers to choose from a variety of customized services to meet their individual on-the-job needs. Staff at CSA and the MRC frequently work closely together. In Armen's case it was no exception. CSA had already determined Armen had the skills and the drive to start his own landscaping business and they knew he could benefit from MRC services. With funding available at the MRC, the supports necessary for Armen to begin his business would be in place.
Armen had the talent, a trailer and some of the necessary tools for his business, but additional funds would be needed to get the business off the ground. Fortunately, good news was around the corner. Angela, who is also a founding member and president since 2000 of the Massachusetts Association for Persons in Supported Employment (Massachusetts APSE), informed CSA about an available grant to help people with disabilities become self-employed. Armen, with assistance from CSA writing his business plan, applied for the grant, crossed his fingers and began to solicit business while waiting for a response. Armen's first customer was Community Support Associates, who hired him to mow the lawns of three of its residential homes, using their lawn mower.
In July, he was awarded a $1,000 grant from Massachusetts APSE and was able to purchase a lawn mower, update and license his trailer, obtain a landfill sticker and advertise in local papers. Soon Armen had six regular customers. In order to extend his business into the fall season, Armen advertised his services as a handyman. During the winter months, he received several job offers installing doors, fixing dry rot, etc. The staff at CSA continue to provide assistance to Armen so his business will thrive. With the growth of a new business comes new challenges, and Armen's job coach has continued to lead him on toward success. Maintaining his current customer base, adding new customers, organizing his work time, keeping proper records and developing off-season work opportunities are skills his job coach has helped him develop. Armen's wife and kids occasionally step in to help out with the heavy workload, especially in the summer months. No doubt, there will be areas where future support will be instrumental in the success of his business. As Marty Gravelle, Director of Employment Services at CSA put it, "Armen has been successful because of his skills and his motivation to work. He has also greatly benefited from the resources and the flexibility of those resources provided by MRC's Statewide Employment Services. Without the funding for self-employment, Armen would not be working right now." Thanks to one determined individual, the support of MRC and CSA's job coach services, as well as funding from Massachusetts APSE, a man's second chance at life and a successful career was born and is blossoming every day. Armen continues to enjoy the independence he has regained through self-employment and has the added advantage of working at something he loves. We wish Seascape Landscaping and Armen continued success in the future.
An individual job coach may provide an array of job related support services for people with disabilities, from securing employment opportunities to helping them maintain their current job. Frequently, the first step for a job coach is to perform an assessment of the consumer's learning style. Then, job coaches can work more effectively preparing individuals with disabilities for employment, providing structure and organization for individuals seeking a job, training individuals on specific job skills, as well as assisting individuals at the job site to maintain employment.
Job coaches may also provide assistance directly to an employer by offering training regarding how to accommodate an employee with a disability on the job site, acting as a liaison to facilitate positive communications between the employee with a disability and the supervisor and/or help to promote social interaction among co-workers.
In many cases, the ultimate goal is to minimize the number of hours the job coach is needed every week. Some times, job coaching services are provided on a long term basis through Extended Employment Services. Job coaching services may be provided to any consumer of the Vocational Rehabilitation Services Program who requires a job coach.
Contact your local MRC office to inquire about services.
If you asked Dawn Yager the key to success in her job, she would have a one word answer: organization. Color-coding, post it notes, and plenty of filing helps keep down the clutter of paperwork and saves time for the important parts of her job. But, there is more to the story than just being orderly. Dawn is soft-spoken and not one to boast, but she is a powerhouse of skills and knowledge. Dawn is a Qualified Vocational Rehabilitation Counselor for the MRC-VR Holyoke office. Her job is based on the professional partnering of people with disabilities with appropriate resources in order for them to embark on the right career path. "I concentrate on bridging the gap between the goals an individual may have and the services that are out there for them. I help them to use the knowledge they have about themselves and guide them in a positive direction."
A VR counselor has an exceedingly personal relationship with consumers. It is necessary for them to get to know a person's skills and vocational goals, as well as many other things about their life; personality, family history, hopes, dreams, fears and obstacles all play a role in the rehabilitation process. "Oftentimes I find consumers struggling with their self-concept because for much of their lives they've been identified solely by their disability. People never bothered to find out who they really were." The steps toward rehabilitation begin with the idea that consumers are on the road to taking ownership of their lives. Through each stage of this progression, be it through training, enrolling in college courses, resume writing or networking, it is a VR counselor's job to identify what is working, what is not working, and what the consumer would like to change.
Dawn has a BS in Criminal Justice with a concentration in corrections. Working for a small non-profit firm that dealt with rehabilitating criminal offenders did not offer her much time with her clientele because of the high turnover rate. However, working for the MRC, she has had the opportunity to spend significant amounts of time with consumers, coaching them on and watching their success, from start to finish. For Dawn, one of the greatest feelings is watching a person develop a completely different attitude after seeing them come in with very little confidence. "It's great when someone calls me up and says 'I want to change something.' Voicing their opinion helps give consumers a sense of self they may have never had before," says Dawn.
Organization is just one factor helping Dawn to accomplish her goals. She also attributes her job success to the people and philosophies of the MRC. A comprehensive explanation of policies and procedures for her particular job title, in the form of a manual, lays the groundwork for her knowledge, but the real help comes from her co-workers and supervisors. "At the MRC, there is an open door policy. I never have to think twice about asking a question or seeking help. People are always willing to brainstorm and share their past experiences. There's no competition because everyone's working together toward a shared goal, all while developing as professionals." Counselors and supervisors meet periodically to discuss difficult cases and utilize the internal staff support system.
One example of the system at work is through one of Dawn's consumers, "LP." LP is a 40 year-old, single female who applied to the Commission primarily for counseling and guidance services and was also interested in assistance with job placement. LP had been diagnosed with Post Traumatic Stress Disorder, Bulimia Nervosa and Adjustment Disorder with mixed anxiety and depressed mood. She also has a history of dyslexia traceable back to grade school and operates with low to average cognitive functioning. Her areas of functional limitation are specifically with work tolerance and interpersonal skills.
LP had a poor work history and had been hired and fired from numerous clerical positions in the past. The Commission had once previously provided training for her to become a fingernail technician. She obtained a position successfully, but was fired due to a tumultuous relationship with her employer. Now, she no longer has the desire to pursue this career due to her difficulties in performing the tasks necessary to be successful in that field.
LP started working more closely with Dawn as they began an in depth process of choosing a career path. Together they determined LP had an interest in working in an office using a computer. Dawn saw the need for LP to build up her skill levels in office administrative work in order to be successful in this highly competitive job market. Dawn set up a typing evaluation to determine LP's accuracy and speed. She also set up informational interviews for the purpose of finding out about the particular skills needed in the jobs that were of interest to LP. Her interaction with employers and gathering information about jobs would help build LP's confidence.
Dawn also believed LP could benefit from a rehabilitation/training program. If LP could learn higher level skills and successfully complete a training program, she would more likely be successful finding and keeping a job. They both felt LP would also benefit by participating in individual therapy. Therapy could help LP to look at life issues getting in the way of her personal and professional success. When consumers are having a difficult time, Dawn likes them to feel they have a close point of contact. Dawn encourages weekly call in times so they can feel secure knowing someone is in their corner while she helps to keep them focused.
As of this date, LP is working a few hours each week at an education training center as a site aide. Her responsibilities include using some office skills and being a resource to the younger students. LP is now one semester away from earning a Certificate in Office Systems Programs from Holyoke Community College (HCC) updating her computer skills.
Meanwhile, when LP started attending classes at HCC, Dawn continued her own education at Cambridge College where she completed her Comprehensive System of Personnel Development (CSPD) requirements. CSPD is an advanced master's degree level training for rehabilitation counselors in state vocational rehabilitation agencies as required by the Rehabilitation Act amendments of 1992 and 1998. Dawn says she, like the people to whom she provides VR counseling services, is "forever learning."
Dawn continues to work with LP and has been able to secure computer software needed to accommodate LP's learning difficulties so she can successfully complete the academic demands of her program. She holds meetings with LP and her support team at HCC to ensure LP gets the services she needs to be successful at school. She is in the process of getting books on tape due to LP's dyslexia to help with her reading assignments. With Dawn and LP committed and dedicated to their work, they are both sure to succeed.
THE BENEFITS OF ASSISTIVE TECHNOLOGYOn May 19, 1999, Linda Gibson applied to the Massachusetts Rehabilitation Commission Vocational Rehabilitation (VR) Lowell Area Office. On her application for services she wrote, "I am no longer able to perform the physical demands of a Certified Occupational Therapist Assistant (COTA) due to Multiple Sclerosis. I am applying for services to determine other job skills I can perform given the relapsing/remitting nature of Multiple Sclerosis."
With the most recent exacerbation of her Multiple Sclerosis, a disease that destroys the myelin, the protective cover on nerves which allows for impulse conduction, Linda Gibson was essentially unable to perform the skills needed for everyday living. She could no longer carry out the physical job functions of a COTA and was having trouble living independently. She experienced limitations in the areas of walking, hand coordination, upper body weakness and mild vision impairments, necessitating the use of a wheelchair.
Her career goals had to change. In addition, she needed to find resources to assist her in making lifestyle decisions. She essentially had to re-examine every aspect of her life and realistically set new priorities and goals.
Working for many years as a COTA in Texas provided Linda with a knowledge of the types of community resources available, as well as the needs of persons with disabilities. Now it was time for Linda to use this knowledge to facilitate her own rehabilitation. She called Judy Green, a Qualified Vocational Rehabilitation Counselor in the Lowell MRC-VR office.
With Judy's guidance, Linda received a wide array of VR services. Clearly, understanding the current status of her disability was a top priority. Dr. Carol Montgomery administered neuropsychological testing to identify areas of strengths and needs. Additionally, Judy referred Linda to the Northeast Independent Living Program (NILP). Joanne Eno, NILP case manager, assisted Linda in applying for SSA benefits and finding accessible housing.
Understanding her new physical limitations provided Linda with the knowledge she needed to begin making career choices. She participated in a slew of vocational assessments, gaining a better understanding of her intellectual abilities and work values. With Judy's help, Linda was able to identify key transferable job skills, interests, self-management needs and barriers. Fully armed with this new found knowledge, Linda made the decision to attend the University of Massachusetts, Lowell to earn a bachelor degree in political science.
To achieve her vocational goals and to live on her own, Linda would need the use of assistive technology (AT). Fatigue and stamina had become major barriers for her and she found parking and traveling between buildings to be excessively tiring. The results of an AT evaluation scheduled by Judy indicated Linda had the ability to better complete her schoolwork with the help of a computer.
MRC provided Linda with a desktop computer equipped with voice activated software and an all in one printer/scanner/fax machine. Linda says, "As a wheelchair user, I face barriers everyday. Having this computer and technology reduces my fatigue level. It is convenient and efficient; I do not have to deal with these barriers everyday." With the help of AT, Linda can carry out her college research, homework and communicate with the school; she has finished several independent study courses using the new technology. In addition, Linda is able to shop online for her household and personal needs, thereby saving time and further conserving her energy. Communication with friends and family has been made easier by an automatic telephone dial directory and speaker phone.
Today, a senior at UMASS Lowell, Linda is a Commonwealth Scholar with an employment goal to work in foreign policy and/or diplomacy. With the help of AT, Linda maintains a cumulative GPA of 4.0. She says, "When I left my job because of MS, I thought I lost everything that was meaningful. Today, with the help of Judy Green and assistive technology from the MRC, I feel reinvigorated and excited to have this opportunity to pursue a career that is purposeful and meaningful, not only for me, but to contribute to the community."
Filomena Tripp applied for MRC services in May of 2001. She requested assistance with modifications for her wheelchair accessible van in order to allow her to continue driving to work and to live as independently as possible. Her 1985 Ford 150 Econoline van was aging and experiencing serious mechanical problems. The driver's seat kept shifting out of position, forcing Filomena's husband to permanently tie down the seat to keep it in place. The van had proven to be unsafe to drive. So, Filomena contacted MRC for services, requesting Vocational Rehabilitation Counselor Mike Fleming assist her with securing a driving evaluation and the necessary equipment and van modifications allowing her to continue to drive.
Filomena has a congenital disability. She has no right or left forearm and no left leg. She has a right leg above the knee, which has a foot, and the ends of both arms have a pad, which act as thumbs. It is with these pads that Filomena is able to grasp objects and operate her power wheelchair for mobility.
Filomena has made very good use of MRC's VR services in the past. She worked with VR counselor Eileen Mello in the New Bedford Office to prepare for and locate employment. Filomena and Eileen developed a work plan to find Filomena a position with the Southeast Center for Independent Living (SCIL) as a peer counselor.
Filomena has been successfully employed at SCIL for five years now. Her responsibilities include peer counseling, advocacy, skills training, as well as being a guest speaker in the community. Her work at SCIL requires her to travel to consumers' homes and visit community service providers. Without access to a van to perform her job duties, she would be at risk of losing her employment as well as her independence.
"Having transportation allows me to be independent, and it's important I have the freedom and capability to come and go as I need to," said Filomena. "Having a van I can drive allows me to work and be productive."
The list of consumers requesting van modifications is long and there are insufficient funds to serve everyone in need in a timely manner. In the meantime, Mike Fleming referred Filomena to Eugene Blumkin, the Assistive Technology Specialist at MRC, to undergo a complete van and driver assessment. Performed by a Registered Occupational Therapist at the South County Hospital in Narragansett, RI, the assessment results identified special equipment that would allow Filomena to more easily operate a new van. MRC paid for the evaluation, documenting her ability to operate the new equipment. The modifications would include a 10" lowered floor, 13" steering wheel with a "cup" steering device, pedal extensions, electric parking brake and electric unoccupied wheelchair tie-down. After being advised by the MRC regarding the type of van she should purchase and have modified, Filomena bought her new van in December 2003. She was able to purchase the van by saving money and taking out a conventional car loan and the MRC covered the cost of the alterations and new equipment. In January, the van was sent to a specialized vendor selected to make the modifications. During the intervening time, with her old van unusable and her new van being in the shop, the MRC funded public accessible transportation for Filomena, allowing her to keep her job and get to work. Problems arose with fitting the van to Filomena's exact needs, but in March she finally received her brand new, adapted van.
Once her van was modified, Filomena was referred to the Adaptive Training Program in Somerset, where she was provided with two hours of training ensuring her proficiency in the use of the new adaptive equipment.
Filomena has been able to keep her job at SCIL as a Peer Counselor since receiving her newly modified van. "It took a long time to get my van, but the wait was well worth it" said Filomena. "I so badly wanted to keep my independence and the ability to work. I never gave up hope that the MRC would get me what I needed."
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 and to advance the use of resources necessary to promote the independence of people with disabilities in Massachusetts. Official members are appointed by and serve at the pleasure of the Governor. The membership reflects 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 Appointees
VOCATIONAL REHABILITATION AND EMPLOYMENT SERVICES FACTS AND FIGURES
Vocational Rehabilitation Services Program
|Number of consumers competitively employed for more than 90 days||2,710|
|Number of consumers in active participation||23,401|
|Number of new consumers with an IPE||4,463|
Facility Based Employment
|Number of consumers who received services||951||918|
|Number of consumers who were placed in employment||16||18|
Integrated Independent Employment
Community Based Employment Programs
|Number of consumers served||484||505|
|Number of consumers placed in employment||180||196|
|Number of consumers who completed program||144||163|
|Number of consumers in extended services||142||176|
Integrated Employment with Support
Supported Employment Program
|Number of consumers served||158||197|
|Number of consumers who completed program||44||45|
Total Consumers placed/retained in employment
Community Services Program Overview
The Community Services (CS) Program of the MRC was established in 1985 and offered programs such as Work Personal Care Assistance (PCA), Head Injury 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 CS programs have steadily grown along with the population of citizens with disabilities in the Commonwealth, expanding its operations early on to include Protective Services and a Home Care Assistance Program. A number of service models have also been developed over the years, such as Supported Living and Turning 22. Most recently, we also began a Nursing Home Initiative assisting individuals with disabilities to move out of nursing homes and live back in their community.
Other significant initiatives this past year have included the multicultural outreach program to people with brain injury from culturally and linguistically diverse communities, the development of a Traumatic Brain Injury Home and Community-based Waiver and an Interagency/Intersecretariat Steering Committee on Brain Injury, co-chaired by the Statewide Head Injury Program and the Executive Office of Health & Human Services staff. We have also established a successful federally funded Transportation Options Project.
Several CS programs continue to have 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 a restrictive environment, such as a nursing home.
In fiscal year 2003, the MRC-CS programs collectively assisted 1,757 individuals to leave or avoid being placed in an institution or nursing home, thereby saving the Commonwealth an estimated $120 million.
Youth In Transition
Kara Johansen and Liz Warren
It looks on the surface like a typical situation. Two young women in their early twenties rent their first apartment and live as roommates. They have their first real taste of freedom. They leave the security of their parents' homes and move out, determined to prove they can make it on their own. Neither can be sure of what the future holds, but they are both certain this move is a step in the right direction. This is the story of Kara Johansen and Liz Warren; two consumers receiving Independent Living (IL) services from the MRC, who happen to have cerebral palsy and whose efforts toward independence resulted in a positive living environment and heartfelt friendship.
At the MRC, the Turning 22 IL Program works hard to assist young adults with their goal of living independently in the community. Judy Friedman and Jim Durant, the Turning 22 Case Coordinators, played important roles in educating Kara and Liz about their post-graduation options. For many young consumers, making decisions about their own life is a new experience. There are many choices available to MRC consumers, from deciding where they want to live to the kind of assistance they need from a Case Coordinator. Kara and Liz even had to choose which MRC-qualified provider they would use for Supported Living services. Such services are designed to empower consumers by promoting the IL philosophy which embraces consumer choice and self-direction. It is important to everyone involved that consumers become comfortable with voicing their opinions and speaking up for their rights or needs.
Kara and Liz first met at the Massachusetts Hospital School (MHS), a residential state school in Canton for youth with disabilities, providing educational as well as medical services. They lived as roommates for one year and when it came time for graduation, the young women began discussing their future plans. "Both of us wanted to move out.
We felt that to be treated as adults, we needed to become more independent," says Liz. Both Liz and Kara strongly believe that part of their inspiration for the move stemmed from the Student Independent Living Experience, a program they attended at MHS. This on-campus program gives students an opportunity to live in a "realistic" group living situation several weeks a year. Students hire and direct their own Personal Care Assistants (PCAs), plan meals together, shop, and make the kinds of decisions that would arise if they were living in their own apartments. "It was run by a man who used a wheelchair, was married and had 3 kids," recalls Kara. "It made me realize I also could do anything I wanted, if I just put my mind to work."
Kara first met Judy and Jim while attending her local public high school. The school was not able to meet all of Kara's needs, given the complications of her disability, so Judy and Jim worked with the high school staff, attended Individualized Education Plan (IEP) meetings, and advocated for Kara to continue her education at the Mass. Hospital School where she could meet other young people with disabilities and further develop her social skills. At MHS, she also received specialized services, including training to use a communication device giving her the ability to speak and adaptations to a power wheelchair affording her independent mobility. Through these interventions, MHS helped prepare Kara for living on her own. Kara is grateful for the referral to MHS. "Jim and Judy have made a great impact on my lifestyle," said Kara.
Once a consumer has chosen the Supported Living provider with which she wants to work, a Case Coordinator is assigned. Together, they write up a Supported Living Service Plan, detailing the services needed. The plan is reviewed annually and can be modified to better suit the changing needs of a consumer, at his or her request. Kara and Liz each require five hours a week of case coordination services, including assistance managing their PCAs, finances and planning social engagements. It is possible these hours will decrease as they become more adept at managing their day-to-day life independently. Kara and Liz chose United Cerebral Palsy of MetroBoston (UCP) as their Supported Living (SL) service provider. Their SL Coordinator, Kristen Aaron, began planning with both of them when they were still at MHS. This took a lot of careful coordination with UCP, MHS and the MRC Turning 22 Program to plan a successful transition for both women.
Kristen's job was to help Kara and Liz develop goals and make informed decisions regarding the way they want to run their lives. "Kristen is awesome. She is truly dedicated to her job and works very hard," says Kara. When the women first found their apartment in Dorchester, it was clear that modifications would be needed in order for them to have full mobility in their apartment. An on-site apartment evaluation determined that they needed a special lift and modifications to the bathroom to enable them to take showers. MRC-IL provided a Hoyer lift for getting in and out of their wheelchairs and also funded the conversion of the tub into a roll-in shower. The Hoyer lift helps to transfer them to a shower chair their PCA can easily roll into the shower stall.
Although they each receive approximately 56 hours per week in assistance from their PCA's, such as helping them getting in and out of bed and cook meals, the two friends help each other out as well. "For instance," says Liz, "If there's something Kara needs assistance with, like using the phone, I will help her out. I know that other times she will know more about something than I do and will be able to point me in the right direction. One of the areas she has truly helped me with is self-advocacy. Kara kicks me in the butt if I need it, and it really helps me get things done for myself."
Kara and Liz are just two of the many young people with physical disabilities the MRC helps transition into adult services through its Supported Living Program. This program provides youth with disabilities the assistance and safety they need to make a smooth break from dependency on family members. It also removes the frightening prospect of someday being admitted to an institution or nursing home. Although living independently can be difficult at times, Kara and Liz are thrilled to have their own place and be able to make day-to-day decisions. In their words, "It's totally awesome!"
In 1997, Protective Services began investigating a situation that would prove to be a difficult challenge for both consumer and investigator. Yet, the rewards would eventually be a source of great pride and a testament to the true power of the human spirit.
Mary, a consumer with Muscular Dystrophy first received services from the MRC Boston VR office 6 years ago when she requested wheelchair access modifications for her van and had a lift put into her home. Nothing out of the ordinary surfaced until a year later when the Disabled Persons Protection Commission (DPPC) was contacted. Reports of abuse and neglect by Mary's primary caregiver sent up a signal that the case should be reviewed by MRC's Protective Services Department. Once the report was substantiated, Protective Services began taking the necessary steps to eliminate the abuse. In this case, the caretaker was Mary's husband. He was feeling overwhelmed by the duties he performed for Mary, especially at odd hours of the night. For example, if Mary needed to use the bathroom, her husband would need to be woken up to help her into her scooter to get to the bathroom. He became angry when Mary asked for his help. Instead of helping, he started refusing to take her to the bathroom, verbally and physically abusing her if she woke him from sleep. The complaint of abuse stopped soon after it had been reported and it seemed that Mary and her husband had settled their troubles. It was odd that such a situation would be cleared up so quickly, but when a consumer reports the abuse has stopped, the investigator can not continue to investigate.
In 2002, Mary's situation was once again a cause for alarm. Reports indicated that the abuse had worsened. The Protective Services Investigation revealed that Mary had become a prisoner in her own home. She admitted denying the abuse because she felt financially and emotionally dependent on her husband. Without him, there was no paycheck, no PCA and no home. Now, fearful of her husband's abusive tendencies, Mary had begun sleeping in her scooter at night so as not to wake him if she needed to use the bathroom. There were marks on her arms from him grabbing her and he had even punched her in the face once. He made nasty comments about her, neglected his PCA duties regularly and seemed intent on destroying her self-esteem and her independence. In this case, a marriage was in jeopardy, as well as the health and well being of the individual. Fortunately, the MRC was there to help. In any domestic violence case, the first priority is to remove the victim from the abusive situation. Mary's husband was court ordered to leave the house and relinquish his duties as her PCA. Mary's mother took over these duties temporarily.
The next step would be for Mary to become financially independent and emotionally stable. She received counseling and advocacy from her caseworker, Melissa Zeitz, enabling her to break free from the codependent lifestyle with her husband. Once Mary began to see she could get along without her husband, she had hope again. Slowly, her self-esteem was restored and she began gaining more autonomy. Together, with MRC staff, she filled out the necessary papers to file for a divorce. The court granted Mary $150 a week in alimony and shared van privileges with her ex-husband. Mary took up residence with her son, and replaced her mother's temporary help with a new PCA.
These types of transition are not always smooth and Mary encountered significant barriers on the road to independence. For instance, Mary's husband would often refuse her use of the van, even though it was court ordered that they should share the vehicle. It was also common for her husband to refuse to pay weekly alimony. When her husband was reprimanded about his behavior, he demolished the lift in the van, making it impossible for Mary to use it. These obstacles presented a challenge for Mary and Melissa.
The basic foundation of the MRC philosophy is self-advocacy. Mary was now well suited for the role of self-advocate. She developed strength and confidence through her new abuse-free lifestyle. She took the first initiatives to make sure that her rights from the divorce settlement would be protected. She began by calling various pro bono legal services in order to get the necessary repairs for her van for free and to get full possession of the van. She bartered with the mechanics for free labor. She contacted the company that sells wheelchair vans with a trade proposition. Mary organized a presentation outlining her needs, her limited financial resources and suggestions for alternatives to the usual payment method. Instead of cash, Mary promised to do "call backs" for the company three hours a night in exchange for a van. Callbacks would enable the company to monitor customer satisfaction and the donation of a free van would be a tax write-off. It was obvious that Mary was on her way to achieving her goals.
Melissa also made a significant contribution during this time. When Mary's husband neglected to pay his alimony, Melissa personally called him to remind him of his financial responsibility and contacted legal services when he still refused. She supported Mary with counseling, financial planning, the management of PCA's, etc. As Mary's routine became more familiar to her, Melissa had less and less responsibilities. The MRC's Protective Services merely laid the foundation for independence. Mary has built her new life upon this foundation and has been extremely successful in doing so.
Mary's case will soon be closed. This means success for both Mary and Melissa, as a closed case equals the elimination of abuse. To make sure this kind of situation doesn't reoccur, preventative measures are taken in the form of education, counseling, and check backs for the consumer. It is important for a consumer to feel he/she is safe from their abuser and living in a stable environment. Without financial assistance and counseling, Mary may have felt that she'd have to take her husband back and put herself in a dangerous position again.
Mary currently lives with her son in Taunton. Emotional stability, independence from her husband, and self-advocacy all contributed to a successful outcome. With the support of MRC Mary has begun a new life, a life where she is in control. Her determination and resourcefulness will certainly keep Mary on track toward future goals. "This woman never gave up. If something got in her way, she fought back harder. She is a true optimist," said Melissa.
"When I was born, the doctors told my mom that I wouldn't survive the night. I pulled through and proved everyone wrong. My mom tells me this story all the time. That's how I know I was put on this earth to really do something - I survived for a reason." Normand was born with clubbed feet and endured many painful operations throughout his childhood and adolescence.
At age 14 he remembers having to quit baseball because of another operation. Despite this, Normand has led a very active life. At age 19, Normand began shaping his future. He received his GED and attended Job Corps, training for auto body certification. He worked in several different jobs and found a position with a collection agency that seemed a perfect fit with his outgoing nature and easy way with people. Very early on, Normand was noticed for his "can do" approach and was recommended for a promotion to management. He and his girlfriend Angie were making plans for their future together and life in general was right on track.
But then, in September 2002, Normand's life changed forever. He was riding in a car with a friend when they came upon a sharp curve. Because his friend was driving too fast the car crossed into the opposite lane and hit the guardrail. None of the other passengers were seriously injured but Normand had to be Life Flighted to Boston Medical Center where he was treated for severe injuries. Normand sustained a spinal cord injury and would most likely be paralyzed for the rest of his life.
After the accident Normand experienced excruciating pain from crushed vertebrae and nerve damage. The first weeks in the hospital were spent drifting in and out of consciousness. Finally, two months later Normand underwent spinal surgery. When the operation was over, he was surprised to find more movement in his upper body than anyone had expected. He soon began physical therapy to increase mobility, approaching it with his usual "let's do it" attitude. His efforts seemed to be paying off. As his hopes were raised, unfortunately, Normand's skin began to break down. He lost over 100lbs from his hulking 6'3" frame and his medications were causing drastic mood swings. "I just didn't want to wake up another day in pain."
Unable to return home, Normand was moved to Needham Nursing Home. It is here that he began his work with the MRC. Normand wanted to move out of the nursing home and live on his own in the community again. Cindy Wentz, Program Coordinator of the Nursing Home Transition Unit in the Community Services Program, reviewed Normand's history and set up a time to meet with him. The goal would be to assist and guide Normand in becoming more independent and make a smooth transition back to living in the community. Normand's immediate goals were to have control over his own schedule and finances, as well as an increased understanding about his disability.
As with all consumers, an MRC case manager performs an evaluation to find out what type of services would be required to support Normand in a community setting. More importantly, they talked extensively about the future and the type of goals he wanted to achieve. The assessment process is comprised of many different categories - the consumer is asked if they need assistance with personal care, financial management, housing, housekeeping services, medications, adaptive equipment, vocational training, transportation and other needs. Normand needed help locating housing, managing PCA's, setting up transportation to medical appointments, and ordering medical equipment and supplies to accommodate an independent lifestyle.
In May, Normand felt ready to leave the nursing home. He was making excellent progress both physically and emotionally. MRC helped Normand get a state of the art wheelchair, giving him greater mobility and making it easier to be lifted from the chair. He received 72 hours of PCA services a week including help with ordering his medications and scheduling his appointments.
When Normand expressed an interest in having his own apartment, MRC supported him. They helped him research housing possibilities and reviewed the legalities of renting. Once he had found a place, MRC was there again. A team of experts evaluated the apartment building and grounds for optimal accessibility. This particular building seemed like a good choice. There were automatic doors for entry into the building, a public bus came to the building several times a day to bring residents wherever they needed to go in the area (the bus was also wheelchair accessible), and elevators to the top floors were spacious and reliable. A few adjustments were made to Normand's apartment such as installing a roll-in shower for the bathroom and a Hoyer lift to transfer Normand from his wheelchair to the bed. With this equipment, attendants and case coordinator services, Normand began rebuilding his plans for the future.
It's been over nine months since Normand started living on his own. He sees Lynn Mulligan, case manager from Habilitation Assistance Corporation, once a week and talks with her about issues concerning his daily care."Sometimes I get so frustrated because of my aches and pains or because of the little tasks that I can't perform by myself. Lynn helps me stay calm. She lets me talk about how I feel and does not judge me. She tells me to stay positive and reminds me of how far I have come. That helps keep me focused."
Despite all the challenges in his every day life, Normand is glad to live on HIS schedule instead of a nursing home's schedule. "My goals for the future are to stay healthy, stay out of the hospital and just keep going. Every day I want to take it to the limit." He feels that his family, friends, Angie and Lynn are the reasons for his successful transition. Normand also admits there are times when it is hard for people to see him take some risks or just do something by himself. "I constantly have to work through this. The people at MRC helped me see what I CAN still do instead of what I can't. Though the crash is a defining moment in my life I do not want it to define the rest of my life."
Normand was also assessed for an adaptive computer at UMass Dartmouth. This computer will help Normand manage his schedule at home and set up appointments. It will also help with school and work. Normand has expressed interest in peer counseling and speaking at high schools about safe driving. He believes there is nothing like the voice of experience, of being there and going through it and still getting up each day to do it again.
With funding from the state through the Statewide Head Injury Program (SHIP) of the Massachusetts Rehabilitation Commission and the Department of Transitional Assistance, the Stony Hill Transitional Living Program in Wilbraham, MA just opened its doors. Located at the Pines Community Center, the program offers temporary living arrangements to homeless consumers with a brain injury. Overseen by The Carson Center for Human Services, Inc. of Westfield, program director Beth Edelberg-Cardillo and her staff provide residents with psychiatric therapy, drug abuse consultation, case management, food stamps, bus passes, financial and employment assistance, and aid in locating permanent housing.
Following an application and criminal record screening, residents are permitted to remain at Stony Hill for up to two years. Residents pay 30 percent of their income to the 24-hour a day, seven day a week program, which has two staff members on every shift with homeless or human service experience. With room for 13 consumers, residents have injuries with causes ranging from a mugging to automobile accidents. The tie that binds them is the brain injury received as a result of an abrupt stop of the body but continued movement of the brain inside the skull. The head may be hit by a moving object, may strike a stationary object or be shaken violently. This can occur during a car crash, a serious fall, an act of violence or during another type of accident.
A serious brain injury can occur without signs of injury to the face or head such as cuts or breaks in the skin. The result is often difficulty in memory, judgment, organizational skills, decision making and physical activity.
People who have become homeless with a brain injury are often misdiagnosed and misunderstood in the shelter system. They are often not able to follow through with things such as basic daily appointments, completion of paperwork, or applications for public benefits and services, due to decreased cognitive functioning caused by the brain injury. Since memory is often affected by a brain injury, it is difficult for these individuals "to remember to remember" to sign up for a bed at the shelter, which adds to the instability of their situation. At times these consumers have been banned from a shelter for not following the shelter rules that they either did not remember or did not comprehend in the first place. A transitional living program such as Stony Hill allows these individuals to have a stable environment in which to reside. They have the privilege and stability of having their own room with their own bed each night. Their basic needs are met with scheduled meals, medication monitoring and support from the staff and housemates. The daily program addresses the specific clinical needs of people with a brain injury and the myriad of challenges that comes with a history of homelessness.
"What we do is help people understand their head injuries, and find ways to compensate for their memory loss," said Cardillo. " Some of them keep appointment books. Each resident gets an orientation book, and they have scheduled days with meetings every morning, a housing group and groups dealing with alcohol and drug abuse."
45-year-old Mark Wallberg is one of the current residents of Stony Hill. After sustaining a brain injury in a motorcycle accident on Memorial Day in 1994, Mark had no problem receiving speech or physical therapy. The hard part came with the loss of self confidence going from a taxpaying member of society to a homeless person existing between homeless shelters and halfway houses.
"I had good insurance and I was receiving treatment for a while, but nobody talked about my head injury" said Wallberg. "Here I can sit in groups and identify with others who have some of the same problems I have."
Wallberg has found hope in talking with others who have experienced similar injuries and in receiving advice on how to compensate for whatever impairments he still feels in groups and one-on-one sessions.
"When you're living in different shelters, it's not the ideal condition for the human spirit," Wallberg said. "I feel like I belong here, I can sit with the others and say 'Oh yeah, I have that too.'"
According to the Federal Interagency Head Injury Task Force, established by the U.S. Department of Health and Human Services, two million brain injuries occur nationwide each year, with more than 30,000 in Massachusetts.
The MRC has faith that with the new Stony Hill Transitional Living Program people such as Mark will not just be another statistic.
More than a decade after the passage of the Americans with Disabilities Act (ADA), accessible public transportation continues to offer numerous advantages to people with disabilities. Many options now exist beyond the requirements of the ADA through federal initiatives to increase transportation mobility for people with disabilities. However, research still shows that high numbers of people with disabilities are unemployed or underemployed, and 85% of the time, transportation is cited as a barrier.
The lack of affordable accessible transportation continues to be one of the greatest obstacles to the successful employment of people with disabilities. When a person with a disability finds employment, they may need assistance in identifying and finding solutions to workplace barriers, with transportation often being high on the list. It is a particular problem in rural communities where fixed route transit is limited and traditional door-to-door services are very expensive. A survey conducted by the MRC in June, 2003, cites the most frequent obstacle to community employment and economic self-sufficiency for people with developmental disabilities was access to affordable, accessible and convenient transportation.
The MRC's latest attempt to tackle these problems comes in the form of two grants, the first being the Transportation Options Project (TOP), funded in January, 2001 by the U.S. Department of Education, Rehabilitation Services Administration. The purpose of this grant is to increase transportation independence for people with disabilities who live in rural areas and are going to work or are enrolled in employment training programs. The second of these grants is the Rural Transportation Coalition Initiative (RTCI), awarded in October, 2002. While it is similar to the TOP, this grant is particularly designed to increase transportation access in rural communities for people with developmental disabilities
Thus far, the TOP has provided ride solution for 2,625 MRC consumers Transportation Options Managers (TOMs are an essential part of this Project. Through intense training and education, TOM become experts in the business of transportation and disability services. They track the needs of consumers and map out solutions to their problems by maintaining ridesharing databases, regional mapping systems and a detailed tracking system for the transportation needs of people with disabilities. This data also enables agencies to coordinate with regional organizations to ensure the needs of people with disabilities are considered in long term planning for transportation improvement plans. These managers are responsible for organizing ride navigation solutions through a Person Centered Transportation Planning process that matches a person's unique transportation needs to available solutions.
The latest hi-tech solution involves a partnership between Bridgewater State College (BSC), Hewlett Packard, Compaq Computer, Verizon Wireless and the Cape Cod Regional Transit Authority. This collaboration involves the distribution of Personal Digital Assistants (PDA) and Automatic Vehicle Locators (AVL) using wireless communications in a pilot project being tested in the Cape Cod area. These wireless PDA devices are used to assist people with disabilities with travel planning by predicting the arrival of the next bus or van for transport. The PDA outlines transportation routes and beams the exact location of a bus or van through an AVL transmitter to a satellite using a computer program developed at BSC. From there, the Internet takes over. Consumers can access the information they need through the wireless Internet capability on the PDA via the BSC server. There is also a scheduling calendar option to store travel-planning reminders and commonly used travel routes and schedules, helping people with disabilities better navigate their environments at work and home. The PDA even offers a picture storage function, used to assist people with memory deficits and specific learning disabilities, to identify bus and van stops included in their travel plans. The PDA picture storage and calendar features are being piloted with the MRC's TOP grant project in Massachusetts.
The existence of transportation barriers represents a significant obstacle to the full participation of people with disabilities at work, recreation and social activities in their communities. This problem is being specifically addressed by the MRC, particularly in rural areas where many residents have little or no public transportation, or what is available is frequently found inadequate. Everyone needs reliable, affordable and accessible transportation, if the promise of the ADA is to be fulfilled.
|Consumer Services Facts and Figures FY '03|
|Number of consumers who received services||121|
|Number of new service plans||115|
|Number of consumers provided paid services||106|
|Number of investigations||278|
|Head Injury Services|
|Number of consumers who received services||570|
|Number of new applicants||271|
|Number of services purchased for consumers||721|
|Home Care Services|
|Number of consumers who received services||1,515|
|Number of new cases opened||491|
|Number of hours of services provided||242,185|
|Turning 22 Services|
|Number of consumers who received services||74|
|Number of consumers in Supported Living services||40|
|Number of new Individual Transition Plans developed||8|
|Number of new referrals||14|
|Supported Living Services|
|Number of consumers who received services||91|
|Number of consumers on waiting list||45|
|Number of new listings||649|
|Number of vacancies||220|
|Number of "hits" on MassAccess Website||29,000|
|Assistive Technology Program|
|Number of consumers who received services||195|
|Number of consumers on waiting list||74|
|IL Center Services|
|Number of consumers who received services||6,290|
|Number of Information and Referral calls||9,993|
|TOTAL CS CONSUMERS SERVED||8,856|
Disability Determination Services Overview
Every state in the USA operates a Disability Determination Services (DDS) program responsible for providing medical/vocational decisions of behalf of those making application for Social Security Disability and Supplemental Security Income benefits. Last year, the Massachusetts DDS processed a total of 84,978 claims which represents an increase of 2,228 claims from the previous year. The Social Security Administration measures the performance of all DDS's annually and the Massachusetts DDS is recognized as one of the most productive in the nation. This translates to quicker decisions for Massachusetts residents with disabilities making application.
The Massachusetts DDS is innovative in the services it provides, especially to the most vulnerable populations. There are DDS specialty staff who provide services to the homeless population as well as to those with HIV, resulting in better relationships with community providers.
The Massachusetts DDS continues to be a resource for SSA's Region I (New England). When other states are having difficulties in remaining current with the workload demands, the Massachusetts DDS assumes jurisdiction for these cases.
The Commonwealth reaps tremendous benefit from the services provided by the Massachusetts DDS. Not only do some of the state's most impoverished and disadvantaged citizens get the critical financial and medical support they need, but also the Commonwealth benefits as these claimants receive and spend over $200 Million in benefits annually.
DDS Advisory Committee Members
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.
SARAH ANDERSON, Boston • CHRIS CZERNIK, Lynn • SHIRLEY DOPSON, Jamaica Plain, TARAMATTIE DOUCETTE, Boston • GAIL HAVELICK, Boston • EMILY HERZIG, Lynn • BETTY J. KING, Boston • LINDA LANDRY, ESQ., Boston • KATHY MOONEY, Salem • ST. FRANCIS HOUSE DIRECTOR, Boston • BARBARA SIEGEL, Boston • JOANNE SHULMAN, Framingham • AUGUSTINE UGBOLVE, Jamaica Plain • FRANCIS VERVILLE, Fall River
Communication is one of the key ingredients for success in any business or organization. At the MRC, it is imperative for all departments to be able to communicate effectively with consumers, businesses and each other. Many staff members are involved with maintaining this clear and organized communication system. One such employee is Thomas Simpson of the DDS Worcester office. Thomas plays a unique role at the MRC; in fact, he plays two. His passion and dedication for preserving communicative harmony is expressed in both of these challenging positions.
As a systems analyst for the IT department, Thomas is responsible for resolving all issues regarding the computer network. Without his help, the well-ordered system for managing working files, email and other internal communications would be lost. For Thomas, this past year his job took on extraordinary duties, as every server and desktop computer at the DDS was replaced. The Worcester office went first and Thomas was the point man for the state, orchestrating the various stages of this massive effort. He coordinated the teams who assisted in making this transition seamless, meaning that hardware was exchanged and systems installed only at night and on weekends, with not a single workday being lost. In order to ensure that all employees understood how to perform their job with the new system, Thomas was heavily involved in training the DDS Vocational Disability Examiners in the Worcester office.
Thomas also acts as the Chairperson of the MRC Diversity Committee. This volunteer role enables Thomas to help MRC employees communicate cross-culturally. The Diversity Committee exists as a resource for the entire MRC constituency. Its members provide information, training and referrals to better serve the diverse community of people with disabilities in Massachusetts. Al Jones, the MRC Civil Rights Officer, first invited Thomas to a Diversity Committee meeting. After being a member for a year and 1/2, he was elected as chairperson. There are heavy responsibilities that come with this title. The group sets team goals and it is his job to see these goals are being met. Organizing meetings, discussing issues, 39 exploring opportunities for future workshops and trainings also come with the territory. "I became involved with the Diversity Committee because it lets me learn about different cultures. I can better understand why people respond in certain ways and learn how to ask the right questions." Over the years, the Committee has made various efforts to reach their goals. Sending pamphlets to vendors and various other organizations, keeping databases with resources in the community, providing programs and training for providers, as well as staff, are all examples of these efforts.
Thomas has a very strong commitment to diversity training and endeavors to bring cultural awareness and cultural understanding to all aspects of his work. Thomas is also cohost of the AM 1310 WORC radio show "The African American Forum." The radio show airs each Monday evening from 7:00 p.m. to 8:00 p.m. covering educational, legal and political issues, as well as highlighting newly published authors and topics. Thomas had no prior experience in broadcasting and was introduced to this area by Keith Cooper, a co-worker at the DDS and host of "WORC Time Portal music." Keith asked Thomas if he knew anyone to recommend as a host for a local radio show, and Thomas immediately recognized this as an opportunity for him to make a positive contribution to the local community. Thomas found a great co-host, Tony E. Smith, and since both have full-time jobs, they share the responsibilities of organizing the show. Thomas pursues and schedules national guests and authors and also designs the flyers.
Thomas is hopeful that continuing communication about all aspects of diversity will diminish tensions among cultures and races. Within the MRC, he sees a bright future for the Diversity Committee and a continuing commitment to embracing diversity, which should lead to continued success as an organization. Communication is the key to a successful organization and the intercultural communication provided by group members has been successfully installed into the communication objectives for MRC.
For 15 years, the Massachusetts Rehabilitation Commission's Disability Determination Services (DDS) Program has been actively involved with issues concerning homelessness. The Boston DDS office has a well-established Homeless Unit, founded in 1985, and it is still the only one in the nation. The Worcester DDS office began paying closer attention to homeless claims in recent years through the effort of the DDS Advisory Council's Subcommittee on Homelessness. Although a specific Homeless Unit does not exist at this time at the Worcester DDS office, representative staff are involved and committed to working on issues concerning people who are homeless.
The Subcommittee on Homelessness was quite active during its inception in the late '80s-early '90s. It was reactivated in 1999, coming back with full force and vigor. This Subcommittee is comprised of legal service workers, social service providers, homeless advocates and staff from both the Boston and Worcester DDS offices. The initial impetus for reactivating the Subcommittee stemmed from concern over a lack of relevant information regarding homeless claims. In addition, there was concern regarding the role of the Social Security Administration (SSA) field offices in both taking homeless claims and adequately "flagging" them for the DDS offices.
In the past 4 years, the Subcommittee has made a tremendous impact and several noteworthy accomplishments. Homeless claims now arrive at the DDS with a special flag that 41 has been attached by the local SSA office. These flags allow the case folder to be clearly distinguished as a homeless claim. As a result, each homeless claim is expedited throughout the DDS system, from assignment of the case to the appropriate DDS Examiner knowledgeable about the particular issues involved with homelessness, to procuring consultative examinations and on to the analysis of the case by DDS medical consultants.
The Worcester DDS office identifies and works with homeless claimants, community advocates and SSA field offices, and participates in and makes significant contributions to the Subcommittee's work. The Subcommittee has sought and received statistical information from DDS on homeless claims and found that claims from people who are homeless comprise only a small fraction of all DDS claims (1-2%), yet denial rates are statistically higher (10-15%) than for the non-homeless claims.
Subcommittee members, in conjunction with DDS staff, have been tracking the reasons for denial and attempting to identify what can be done to remedy the situation. One of the solutions was to create Informational Outreach Brochures (see sidebar, page 42) for homeless individuals and advocates, written in several languages, which have been distributed throughout the state. They also developed a one page Observational Form for shelter and outreach staff to easily complete in support of a disability application, particularly when medical evidence is lacking. Lastly, they have designed a new Activities of Daily Living (ADL) form that more appropriately fits the environmental parameters and daily life of a homeless individual.
In May 2003, Governor Mitt Romney signed Executive Order 447, launching a statewide coordinated plan to assist homeless individuals and families in Massachusetts. In a letter to MRC Commissioner Elmer C. Bartels, Romney explained the intent of his plan was "to improve access to and delivery of services for homeless families and individuals, better coordinate services and close gaps in services among executive agencies, and to recommend actions to end homelessness as we currently know it."
Several steps have been taken within the MRC to meet this challenge. In 2003, MRC staff members met to discuss the homeless initiatives within the agency. In addition, MRC participated in interagency meetings to plan cooperative ventures aimed at MRC's consumers who were homeless.
"Teddy M" is but one example of the success and hard work of the Homelessness Subcommittee and the excellent work of the DDS Homeless Unit. Homeless for most of his adult life, Teddy had applied for Supplemental Security Income benefits almost a dozen times, but was always turned down because of failure to cooperate. A chronic alcoholic, Teddy seemed to show little hope of being rehabilitated. When Eileen Daley, a Vocational Disability Examiner in the Boston's Homeless Unit, received his case, she immediately contacted Teddy's case manager at Pine Street Inn to arrange for a medical exam, the first step in certifying a disability exists. Although it took a few attempts, Teddy finally attended a medical exam and, as expected, met the criteria for being a person with a disability; the many years of alcohol abuse had severely impaired his cognitive and physical functioning. He was awarded disability payments and a third party was named executor of his funds. As a result,Teddy was able to secure housing and is currently enrolled in a rehabilitation program.
In addition to the Subcommittee's specific accomplishments, both the Boston and Worcester DDS offices are very actively engaged in connecting with staff from various provider networks and organizations.
The Boston DDS Homeless Unit is coordinating an effort to have Social Security disability applications taken at a Department of Transitional Assistance emergency shelter. The three agencies (DDS, SSA and DTA) are eager to establish a successful pilot program in hopes of expanding this type of service to other homeless shelters within Massachusetts. The results of the work of the Subcommittee on Homelessness have been most rewarding, the outcomes successful, and the sustaining energy for future projects not only impressive but also commendable.
SUBCOMMITTEE ON HOMELESSNESS
INFORMATIONAL OUTREACH BROCHURES
Two separate Informational Outreach brochures act as guides for people with disabilities who are homeless and their advocates. The "Social Security Benefits for Homeless People with Disabilities" brochure details the Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) Programs. It describes how homeless individuals receive benefits and their rights when applying for services. It also outlines tips to assure applications get accurate and proper attention. "An Advocate's Guide" lends a detailed explanation of how homeless individuals can benefit from having assistance from an advocate. In addition, it outlines the steps needed for obtaining, completing, detailing, flagging and following up SSI applications.
DDS Facts and Figures
|Total Receipt of Cases||84,978|
|Total Disposition of Cases||81,923|
|Initial Claims Filed||52,036|
|Continuing Disability Review (CDR) Receipts||17,481|
|Continuing Disability Review (CDR) Dispositions||16,121|
|Consultative Examinations Purchased||23,969|
|Consultative Examination Rate||22.2%|
|Medical Evidence of Record Purchased||60,491|
|Medical Evidence of Record Rate||70.4%|
|Total Medical Costs||$6,683,293|
|Cost Per Case||$393|
|Accuracy of Decisions as Measured by SSA||94.5%|
|Total Population (Massachusetts)||6,400,000|
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 a MRC staff person.
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 the consumer 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 in all MRC 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 in Boston.
Warren L. McManus
Warren L. McManus, deputy commissioner of the Massachusetts Rehabilitation Commission, passed away December 30, 2003. Warren headed MRC's Vocational Rehabilitation Services program for more than two decades. Hired by Commissioner Elmer Bartels in 1978, Warren was the "calm, cool and collected" type, who tried to help employees get through sticky situations while avoiding red tape. The Boston native was working as executive director of the Worcester County Rehabilitation Center when he was hired by the state. Because of his nonprofit work, "he knew the difficulties and he knew how to be helpful," Bartels said. Those who worked with him said he mentored younger staff members, persuading many of them to finish college or helping them get training that would allow them to be considered for promotions.
Warren received a bachelor's degree in education from Boston State College in 1961. During his tenure with the state, which ended with his retirement in May 2001, "he never got flustered about a situation no matter how difficult it might be and he is missed," Bartels said.
Executive Office of Health and Human Services
ELMER C. BARTELS
Commissioner of Rehabilitation
THE MASSACHUSETTS REHABILITATION COMMISSION
Fort Point Place • 27 Wormwood Street, Suite 600 • Boston, MA 02210-1616
617-204-3600 (voice) • 617-204-3868 (TDD) • 1-800-245-6543 (toll free) • 617-727-1354 (fax)
This document is available in alternative formats upon request.
This information provided by the Massachusetts Rehabilitation Commission.
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