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Massachusetts Rehabilitation Commission Mission Statement

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.

Executive Management Team

ELMER C. BARTELS
Commissioner of Rehabilitation

JOHN A. CHAPPELL, JR.
Deputy Commissioner, Community Services

KASPER M. GOSHGARIAN
Deputy Commissioner, Vocational Rehabilitation Services and Disability Determination Services

JANNA ZWERNER
Chief of Staff

Features

A Message from Commissioner Bartels

Dear Colleague:

I am pleased to present this year's MRC Annual Report, focusing on the theme of MRC as a "Bridge to the Future." Through the stories included here, we can more deeply reflect upon a handful of consumers who have benefited from the services provided by the Commission over the years. Many of these individuals entered the job market and embarked upon a career based on their educational background and continuous learning while in the workplace.

During the past several years, we have expanded and developed programs within the agency to enhance the ability of people with disabilities to become independent in the community. This variety of programs includes homemaker and supported living services, protective services, a more comprehensive array of Assistive Technology and services for people with traumatic brain injuries. All of these programs, along with Medicaid and Medicare support services, provide the context for many people with disabilities to live in the community, and in doing so, become able to compete in the job market through the agency's Vocational Rehabilitation Services Program. This continuum of services has allowed people with disabilities to join the working world, sometimes for the first time, to stay in the working world with supports, if needed, and to develop a meaningful career along the way.

A strong driving force within the Rehabilitation Commission is our desire to continuously improve the variety and content of our services in order to stay relevant to the needs of people with disabilities, today and tomorrow. Our staff is committed to continuous improvement as professionals in the business of promoting independence and rehabilitation in the broadest sense.

It is my hope that you will find this Annual Report interesting and reflective of the needs of the people with disabilities we serve and their ability to benefit from the services we provide

Elmer C. Bartels
Commissioner

VOCATIONAL REHABILITATION SERVICES PROGRAM OVERVIEW

The Public Vocational Rehabilitation (VR) program of the Massachusetts Rehabilitation Commission receives close to 80% of its funding from the federal government through the Rehabilitation Services Administration in the Office of Special Education and Rehabilitation Services, under the Department of Education. The effort to assist people with disabilities in becoming employed and financially independent dates back to the Smith-Fess Act (PL 66236) 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 2004, the MRC-VRS program helped more than 3,000 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 the Massachusetts and federal government 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 ended with a rolling Wait List of only four months. We have been able to maintain the rolling four month Wait List throughout FY 2004. 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 and years 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 membership on its 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.

Nursing a New Business

Sandra Jutras swears all the time! Sworn in, that is. As a self-employed legal/medical consultant, she is frequently called upon to provide expert testimony in court regarding health-related and insurance litigation cases.

Sandra's dream job was to become a family nurse. She earned a Bachelor of Science Degree in Nursing from Salem State College in 1984. In 1995 she earned both a Master's Degree and Certificate as a Family Nurse Practitioner from Boston College. For more than 20 years she enjoyed a rewarding career as a Master's level Advanced Practical Nurse and Family Nurse Practitioner.

Unfortunately Sandra was forced to give up the career she loved so much when she was diagnosed with Advanced Degenerative Disc Disease and a Severe Systemic Latex Allergy. Sandra became unemployed and began receiving Social Security disability benefits.

But Sandra was determined to return to work. She applied for services from the MRC in our Lawrence Vocational Rehabilitation office knowing full well that she could not return to direct care nursing. However, Sandra desperately wanted to continue working in the medical field. Given her extensive knowledge of nursing and her transferable skills, she devised a new employment plan with her MRC-VR Counselor, Paula Santagati.

Paula was extremely impressed with Sandra. "I knew from her initial meeting with me that Sandra was determined to get going. At the time there was an extensive wait list for services but Sandra was undaunted."

Uncertain about how any work income would affect her Social Security and medical benefits, Paula first referred Sandra to Linda Muse at MRC's Project Impact. Project Impact is a collaborative program between the MRC and the Social Security Administration and provides benefit planning to Social Security recipients who want to return to work. The information and financial planning she received from Linda was extremely valuable and helped Sandra feel more confident regarding moving ahead with a new vocational plan.

With encouragement from her VR Counselor, Sandra thought she would make an excellent medical consultant given her extensive medical skills and continued interest in the field. The first step in her career change was enrolling in the Medical Legal Consulting Institute in Houston, Texas, offering a home study program in which Sandra was able to participate via her home computer and a series of lecture videotapes.

She successfully completed the program and passed a test administered by Prometric required for certification. With her newly acquired skills, plus her extensive background in nursing, Sandra was ready to start her own medical/legal consulting business.

Now that the first few hurdles had been passed, Paula recommended that Sandra learn some basic entrepreneurial skills to help her run her own business. She referred Sandra to the Neighborhood Business Builders for a 16-week "business boot camp." The program taught her everything from how to develop a sound business plan, market her business, set up a web site and understand the legal principles necessary for self-employment, to, of course, the importance of networking.
The MRC-VR Program provided funding to Sandra to assist her with some of the start up costs of her business, including a high quality laser printer and some basic advertising. MRC also purchased subscriptions to professional periodicals that allowed Sandra to identify doctors who could benefit from her expertise.

Sandra has been successfully self-employed for more than four years now. She helps attorneys understand the medical and nursing issues involved in a case. Sandra prepares the medical phases of cases for lawyers who are bringing forward malpractice claims on behalf of patients. She consults on nursing and medical care, patient deaths and emergency room errors. On occasion, Sandra testifies as an "expert witness" before a judge or jury in the trial phase of a case.

Most of Sandra's work is accomplished over the telephone or through e-mail. Her home-based business is flourishing and she works on approximately 25 cases from all over the United States each year. In addition to her successful business, Sandra has also been employed by the University of Massachusetts to teach a nursing course.

Sandra is very grateful for the comprehensive services she received from the MRC-VR Program and VRC Paula Santagati. "The key to my success was Paula getting me into the appropriate training program to learn how to operate my business. Paula was absolutely the best cheerleader you could have. I had a goal and knew where I wanted to go and Paula helped me get there."


Engineering His Own Success

Edouard Sandoz' life suddenly turned upside down after a motorcycle he was driving veered out of control during a race at the New Hampshire International Speedway in 1997. The result was a C-5/6 spinal cord injury causing paralysis of his lower and weakness in his arms and hands. Ed faced seemingly daunting challenges to adjust to and overcome his disability, to live independently and to re-think his career.

Ed spent several months receiving intensive medical care from HealthSouth Rehabilitation Hospital in Woburn. With a great deal of effort on his part and the support of his family, he was able to move into accessible housing in Upton, Massachusetts.

During the time Ed was in the hospital, he was referred to Nancy LeBlanc, a Qualified Senior Vocational Rehabilitation Counselor with many years of experience in the MRC Walpole Area Office. Ed remembered, "Nancy was devoted to her job. She clearly believed in me, saw me as having capabilities not disabilities. She was dedicated to support me through the process and provide what I needed to help me move ahead in my vocational endeavors."

Nancy was equally impressed with Ed. Nancy said that "Ed's positive attitude, talents, perseverance and high level of expectations he had for himself truly made him the most extraordinary individual that I have had the opportunity to work with in my career with MRC."

Before his accident, Ed earned an Associate Degree in automobile technology at Denver Automotive and Diesel College in Denver, Colorado in 1992. Ed's dream job was to become an engineer. He had been considering returning to college to pursue this goal and Nancy strongly supported Ed in achieving his dreams.

Numerous services were needed to be put in place to assist Ed's career goal. First and foremost would be the financial support to pay for the costs of his education. Modifications were made to his van so Ed could drive himself to classes. Ed would also require driving lessons to familiarize himself with the changes to his van. Because of arm and hand weakness, MRC also provided assistive technology support purchasing him a computer with voice activated software. Ed would also have to be trained on how to use his voice activated PC.

The MRC also assisted Ed in paying for some of the costs associated with his continued efforts to gain greater mobility. For several summers he attended the Shake-A-Leg program in Newport, Rhode Island. The program specialized in body awareness and how to maximize mobility. Ed excelled at this program and made remarkable gains in both strength and mobility. His increased strength allowed him to be less dependent on others for accomplishing his daily living tasks. In fact, he was able to decrease the assistance he needed in his home by 30%. Ed also felt that his increased physical endurance helped him a great deal in dealing with the vigorous schedule of schooling. Ed became a positive role model as he also mentored other participants in the program.

In 2001, Ed earned an Associates degree in engineering from Quinnsigamond College in Worcester. In 2003, he attained his ultimate goal, graduating with a Bachelor of Science degree in Engineering from Worcester Polytechnical Institute.

Just prior to graduation, Ed competed along with 12 other WPI students in a collegiate competition building a small open-wheel racecar. During the competition, numerous recruiters attended, scouting for new candidates for employment with their companies. Ed distributed his resume to several potential employers and 2 months later, Honda contacted him and flew him out for an interview in Ohio. Ed was offered a job shortly thereafter.

Today Ed still has a passion for racing. He has replaced his motorcycles with hand cycles, earning two silver medals at the National Cycle Competition in Binghamton, New York. Ed is still employed at Honda as a design engineer. He loves his job working on the development and design of new vehicles. He now drives to work, lives independently and owns his own condominium.

When asked how MRC and his Counselor Nancy LeBlanc affected him, Ed is very emphatic. Ed feels that MRC had a tremendous impact on his life in terms of education, career and independence. He is very grateful for all of the support and resources Nancy and the MRC gave him to achieve his goals. In particular, Nancy's sense of optimism, validation and encouragement through a long and arduous process, was invaluable to Ed.

Ed's story is impressive. His drive to believe in himself, overcome a serious physical challenge and achieve his dreams is remarkable. Ed received comprehensive services from MRC, but his courage and determination to be successful made the difference.


A Bridge To Rehabilitation

Robert is a good example" of what an individual who has a disability as well as multiple life stresses can achieve if given the right supports." Those words were spoken by Jo Davis, Vocational Rehabilitation Counselor from the Roxbury VR office of the Massachusetts Rehabilitation Commission, regarding former MRC consumer Robert Kinney.

Factors within his family situation led Robert to an addictive lifestyle. Robert was one of nine siblings whose father deserted the family was he was 9 years old. The streets of Roxbury were teeming with drugs and crime. By the age of 12 Robert had started his slide into alcohol, drugs and criminal behavior. "My drug use spiraled out of control, which made me commit crimes such as shoplifting and possession in order to support my habit."
Drugs became a way for Robert to escape his hardships and not face up to the challenges of inner city life. "Life circumstances since childhood were difficult. Much of my drug use started as a result of stress. Medicating myself helped me feel better about my family life. My addiction got the best of me. Not being able to deal with my problems made my drug use even worse."

Most chronic drug users end up in the court system faced with prison or an imposed drug treatment facility. Robert decided on his own to seek help. "I grew tired of being controlled by addiction." Robert voluntarily sought out treatment having the realization that recovery cannot be forced. He also knew that without working on his issues through treatment, he would not be adequately equipped to deal with stressors and to move ahead in his life.

Robert entered FIRST Askia Academy, an alcohol and drug treatment facility in Roxbury. Nathaniel "Nate" Askia along with six other men founded FIRST - For Individuals Recovering Silent Thinking. Askia and the other men were serving time for drug related crimes at Deer Island. During the 1960's, the only treatment was cold turkey, whereby addicts got tossed in a jail cell and medically observed until no signs of withdrawal of the substances existed. Askia organized a movement around drug treatment that was more humane and sensitive to the needs of the addict. Robert was greatly inspired by the ideas of Askia and modeled himself after him.

During his drug treatment at FIRST, Robert was diagnosed with depression. Helping others with similar situations proved beneficial to his recovery. He adds that "turning to helping people made my own depression better." Robert decided not to take medication but instead alleviated his depression through changing his lifestyle including improved nutrition, physical exercise and self-healing. This process of self-discovery and positive change led Robert to want to work in social services in the drug and alcohol counseling field.

Robert knew he would need the appropriate education and credentials to work as a drug and alcohol counselor. Shortly thereafter, he referred himself to the Massachusetts Rehabilitation Commission. Robert worked very closely with his VR Counselor, Jo Davis. Jo gave Robert diagnostic testing and vocational assessments to help refine his career goals and point him toward the right training programs. Jo remarked, "Robert's troubling past is the motivating factor in his passion to turn his life around and contribute to his community." As a result of the MRC's support, Robert earned a Certificate in Drug and Alcohol Counseling from the University of Massachusetts-Boston. During this period Robert received ongoing support from Ms. Davis as he maintained his sobriety and eventually graduated from FIRST Askia Academy in 1991. In order to enhance his career, Robert returned to the University of Massachusetts, earning a BA in Human Services in 1995, with continued MRC sponsorship. "I could not have achieved my goals without the MRC," Robert said.

Askia Academy was so impressed with Robert that they hired him as Director of Client Services. Among his many accomplishments at FIRST was the implementation of a new program, The Family Center. This program educates the families of substance abusers about the disease of addiction and how it impacts the family, and in turn, how the family environment impacts the process of recovery. Robert is also very involved with Drug Court, which allows addicts to avoid prosecution for drug-related crimes by seeking treatments for their substance abuse. People who choose the road to drug rehabilitation must report weekly to Drug Court to give status reports. Robert's role is to develop treatment plans for these individuals to successfully overcome their drug abuse. Robert feels "very blessed to be given the opportunity to be the director of this type of comprehensive recovery program."

The 45 year old Kinney is also actively involved in community-based and national initiatives. He works on voter registration projects, for environmental issues and advocates for ex-offenders and recovering addicts. He is also a volunteer at Boston Connects, whose mission is to help families in urban settings attain economic self-sufficiency and is in an empowerment zone (federally-designated economically depressed area).

Robert's efforts have been recognized by his family, friends and colleagues. In September 2004, Robert received a community service award from Recovery Home Collaborative, a group of drug treatment residential centers across Massachusetts.

"People like me can make a difference in their community. Without the social services I received, I could not have become more helpful to the community, working as I am doing today" explains Robert. "I'm grateful that the MRC exists."


" Careers are for Keeps" An Innovative Employment Initiative

The Massachusetts Rehabilitation Commission (MRC) has established "Careers are for Keeps," a successful career training and job placement program for people with disabilities, in collaboration with Community Enterprises, Inc., a non-profit human service provider, and several businesses across the state. The goal of this initiative is to assist persons with disabilities in their efforts to obtain and maintain career opportunities in their respective communities throughout the Commonwealth of Massachusetts. The project's objectives are to serve Massachusetts residents with disabilities who are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) beneficiaries and/or who are members of diverse racial or ethnic groups.

The MRC and Community Enterprises successfully developed and submitted a grant proposal to the Department of Labor (DOL) to establish this venture. In 2002, the Department of Labor awarded more than $409,000 through a competitive grant process to fund this 3 year innovative public-private partnership. Throughout the year, 'Careers' will serve 50 participants and successfully place 32 people with disabilities into career opportunities based on their individual choices, skills and needs.

The "Careers are for Keeps" project staff have been partnering with several private sector employers, beginning with CVS/Pharmacy Corporation, then adding the TJX Corporation (including Marshall's, A.J. Wright, TJ Maxx and Home Goods stores) and now with the most recent addition of the Big Y Corporation, a supermarket chain in Massachusetts. All partners are committed to developing career and training opportunities for persons with disabilities throughout the Commonwealth. Some of the career opportunities include pharmacy technicians, photography technicians and retail associate positions, to name a few. An individual career training plan and job placement program is developed and tailored to meet the interests and needs of every trainee in this project. Each participant is carefully matched to a specific job, employer and work environment to ensure success and satisfaction for all of the partners involved. A critical feature of this initiative is the availability of an Employment Specialist or Job Coach who helps train and mentor each participant in their efforts to master the essential job duties necessary to be successful in their particular position. Eventually, as the trainee becomes more skilled at the job and can work independently, the employment specialist or job coach visits the work site less frequently until they are no longer needed.

"Careers are for Keeps" has been a win-win situation for both employers and MRC consumers. As an example, it takes a special person like Chad Baker to handle the demands of a busy 24 hour CVS. Working as a merchandiser requires an employee to be responsible, creative and have a keen attention to detail. Chad says he feels "blessed to have this job." He takes great pride in performing his work duties with minimal assistance in spite of his disability, and keeps his work area organized and up to date. Kathy Perreault, a 17 year veteran with CVS and manager of the Fitchburg store, is thrilled to have as reliable and enthusiastic worker as Chad. "He always shows up, never complains and is willing to help his co-workers, as well as the customers. Chad is a valued member of this store's team," boasts Kathy. She is a big supporter of the "Careers are for Keeps" partnership and has spoken publicly about the benefits of this collaborative project.

The Big Y supermarket chain is also very enthusiastic about the program and has recently employed several program participants. Glen was placed at the Northampton Big Y as a service clerk. "The day-time shift is often difficult to fill and we benefited from the training Community Enterprises provided. We also appreciated the fact that CE paid Glen's wages for his first 40 hours of employment. Glen meets our performance standards, is dependable and a strong asset to our customer service department."

Since the inception of Careers are for Keeps in September of 2002, the MRC has maintained outcome statistics on the effectiveness and efficiency of this initiative. During the course of this past year, a total of 56 people were interviewed to participate in the project; of those, 40 individuals chose to participate in the training program this year. As a mark of the program's success, 33 participants have been hired into a variety of jobs and a total of 26 individuals have been employed more than 90 days to date. Compensation ranges between $7.00-$11.50 per hour with associated health insurance, vacation time, and other discount benefit programs.

Lorraine Barra has worked for MRC for 30 years and has a lot to say about the agency and its innovative programs. As the District Director of the MRC's North VR Region, she has oversight responsibility for the 'Careers' project and approximately 20 Employment Specialists. Lorraine says, from her perspective, that the greater purpose of "Careers are for Keeps" is to create tools giving added benefits to employees with disabilities. "We must enhance the resources our vocational rehabilitation counselors and job placement specialists use so people with disabilities can get hired into jobs offering promotional opportunities."

"Careers are for Keeps" is well on its way to meeting and exceeding project goals. Employers in Massachusetts are filling their vacant positions with well-trained and reliable workers. And most importantly, the people with disabilities who need jobs the most are finding rewarding careers.


T he Mechanics of Mentoring

For many people, the exhausting search to find a job leading to a fulfilling and successful career can be extremely elusive. Even the time and energy necessary for locating the most helpful resources to find an ideal job can prove taxing to many.

Julius Adams was not the kind of person to give up when he hit a roadblock. Julius' longing for a job that would offer him opportunities to grow and move ahead is a testament to his unwavering penchant to improve his life situation. He tirelessly looked for jobs and even utilized several agencies that assist people with their job hunt. But once he discovered the Massachusetts Rehabilitation Commission, his way became clear.

In the spring of 2000, Julius met MRC VR Counselor, Carreen Reinhold. Carreen quickly realized that Julius was highly motivated and had promising career potential in spite of the many obstacles facing him. She spent a great deal of time providing Julius with vocational counseling to determine what skills were necessary to be successful in the job market. Julius and Carreen both decided he needed up to date computer skills to increase his chances of finding a good job. Carreen knew about Morgan Memorial Goodwill Industries' Fleet Step-Up program which provided computer training nearby. Carreen approved payment for his training at the program, which Julius successfully completed with Carreen's on-going support.

Carreen saw a remarkable change in Julius after graduating from the training program. When they first met, she had realized that his self-image was low and that would be an area in need of improvement. Successfully completing the training he received from Morgan Memorial greatly increased his self-confidence. Carreen said "Julius blossomed nicely and was re-energized to succeed."

Armed with a better arsenal of personal and professional skills, Julius began his job search again. Carreen referred him to George Mitchell, the job placement specialist in the Roxbury MRC-VR office. George suggested that Julius apply for a position at Jiffy Lube as a technician. The Jiffy Lube representatives were very impressed with Julius, particularly with his newly acquired computer skills, and offered him a job as assistant manager. Both his performance and professional demeanor were stellar and just five weeks after he was hired, Julius was promoted to manager.

Carreen adds that Julius' rapid rise to manager did not surprise her. "Julius is bright and articulate. He identifies problems and finds solutions in such a way that his knack has improved sales. He's an incredibly successful administrator at a multi-million dollar company."

Julius manages the Jiffy Lube in Norwood and oversees a staff of 18. He is in charge of hiring and has hired other MRC-VR consumers to be his Jiffy Lube employees. As was the case in Julius' own situation, he does not focus on their disabilities, but rather looks at their abilities to be outstanding employees. "Julius understands vocational rehabilitation and the job reentry process and that makes the transition into employment for others with disabilities much smoother," remarks Carreen. "You can just see how much Julius wants to give back to the community."

The 40-year-old Adams is married and resides in Roxbury. After his case was successfully closed with MRC, he asked Carreen to assist his wife Barbara with her career goals. In order for her to obtain new skills, Carreen guided Barbara through the same program that Julius completed. She too was successful and is currently employed as a supervisor in an accounting department at Sears.

Carreen has glowing remarks about the dynamic couple. "Both Julius and Barbara have become incredibly successful people. They both started at entry level positions but quickly moved up the career ladder. The marketable skills they developed at the programs MRC funded and the vocational counseling services we offered provided the solid foundation they needed."

Julius is convinced that finding MRC and Carreen Reinhold changed his life.
" MRC basically opened the doors for me to regain my self-esteem, save my family, become employed and find a great career."

Vocational Rehabilitation Facts and Figures FY '04

Vocational Rehabilitation Program
Number of consumers in active participation33,999 Outcomes
Number of new consumers with an IPE5,776 Outcomes
Number of new consumers employed for more than 90 days2,812 Outcomes2,812 in Competitive Employment
Number of new consumers employed for more than 1 year2,474 Outcomes2,474 in Competitive Employment

Community Based Employment Programs Integrated Independent EmploymentCompetitive Employment
Number of consumers servedGoal 600Total 623
Number of consumers who were placed in employmentGoal 175Total 185Competitive 185
Number of consumers who completed programGoal 160Total 174Competitive 174
Number of consumers in extended servicesGoal 180Total 190Competitive 190
Money expended$1,857,146

Supported Employment Program Integrated Employment with SupportCompetitive Employment
Number of consumers servedGoal 200Total 207
Number of consumers who completed programGoal 45Total 0Competitive 45
Money expended$450,180

Extended Employment Program Facility Based EmploymentCompetitive Employment
Number of consumers who received serviceGoal 821Total 826
Number of consumers who were placed in employmentGoal 5Total 0Competitive 7
Money expended$5,081,853
Total Consumers Placed/Retained in Employment • State Fiscal Year • July '03June '04 were 3,049


COMMUNITY SERVICES PROGRAM OVERVIEW

The Community Services (CS) Program of the MRC was established in 1985 (formerly the Independent Living Division) and offers services such as Home Care, Supported Living, Head Injury, Turning 22/Transition services, Assistive Technology and Independent Living Center services. The Consumer Involvement and Statewide Employment Services departments are also part of the larger CS Program.

The philosophy of Community Services holds that persons with disabilities have the right to control their own lives to the extent of their ability and access the same opportunities as people without disabilities. The goal of all these services is to assist individuals to live and work as independently as possible in the community, rather than in nursing homes or other types of facilities.

MRC's Community Services departments have grown along with the population of citizens with disabilities in the Commonwealth, expanding its operations with new services to address those needs. One such need has been developing services to assist individuals who have been placed in some type of institution or chronic care hospital or who are at risk of such a placement. Expansion of the Rolland initiative, the Supported Living Program, and the continued work done by IL Centers are examples addressing the need to live in the community. Another major initiative has been the expansion of access to Assistive Technology, with the receipt of a 1.7 million dollar federal grant to establish an Assistive Technology Loan Program. While technology is often used to assist people with disabilities at work, it can also be used by people in their homes to access information via the Internet, conduct banking and shopping, as well as for general communication purposes.

Significant accomplishments include outreach to people with brain injury from culturally and linguistically diverse communities, the renewal of the TBI Home and Community-based Waiver and national recognition of the MRC Benefits and Planning Assistance Outreach Project.

Home Sweet Home

When Fran DeLoach came to the Massachusetts Rehabilitation Commission seeking assistance in the early 1970s, she was attending high school and attempting to gain work experience. Fran wanted to earn and save money so she could someday live on her own.

Since her early childhood, Fran had lived in the Kennedy Memorial Hospital in Brighton because her family home was not wheelchair accessible. At age 12, she moved from Brighton to the Massachusetts Hospital School in Canton, a residential high school for youth with severe disabilities. While living there and attending high school, she fostered a relationship with the MRC that has lasted nearly three decades.

The MRC assisted Fran in getting a job at a medical supply company in Boston and provided round-trip transportation from high school in Canton to her part-time job. She traveled to work three days a week and on the other two days, attended classes, graduating from high school in 1978. MRC then provided funding for courses at Roxbury Community College, where Fran studied Child Development. She taught preschool children from 1979 to the early 1980s, primarily in day-care settings until she became a teacher's assistant with the Head Start Program. After that, Fran worked at the Children's Museum helping to explain exhibits to kids and finally landed at Children's Hospital, working for 5 years until health reasons caused her to retire in 2003.

During her working years, Fran used her unique talents to benefit the greater Boston community, providing consultation and educational workshops on disability issues to schools, medical centers as well as businesses. "Much of what I did related to sensitivity training," Fran said.

Fran was born with Osteogenesis Imperfecta, a type of brittle bone disease. She uses a wheelchair, has a hearing impairment and is of small stature, so she is limited in her ability to complete all the necessary tasks to maintain independence. She has been living independently since 1979 and since that time, has relied exclusively on the MRC homemaker program to meet her daily needs.

Back in the 1970's, when Fran began planning to move into her own apartment, she did not qualify for the MRC Personal Care Attendant Program because she could manage her own personal care. However, Fran was eligible for the MRC Home Care Assistance Program (HCAP) which gave her just the right amount of support she needed.

Director Betty Maher emphasizes that HCAP is a safety net that fulfills an enormous role in every community in the Commonwealth. "People underestimate the importance of maintaining basic household needs. Our services provide the foundation for independence for individuals with disabilities, maintaining their needs for food, shelter and clothing. It is hard for many people to even think about other aspects of their lives, such as work or school, until these basic needs are adequately met," Betty said.

The HCAP serves more than 2,000 people with disabilities across Massachusetts every year. The MRC contracts with approximately 70 providers, such as Home Health Care agencies, to assist consumers with their daily basic needs. The Home Care Assistance Program is run by ten case managers and a handful of supervisors and support staff working to maintain this vital option for people with disabilities who do not qualify for other community-based supports and services.

"The Home Care Assistance Program is an amazing program," Fran adds. "Because I live alone, MRC's program has helped me incredibly." Homemakers do grocery shopping, laundry, meal preparation, and light house cleaning, tasks she can not complete herself.
Fran views MRC's Home Care Assistance Program as a life-enhancing service for people with disabilities. Without these services, a person with a disability like me could not achieve their independence and I might still be living in an institution," Fran said.

During the past several years, Fran has experienced complications with her disability and medical setbacks eventually caused her to retire from her job. Always the activist though, Fran did not let this get in the way of her decision to be heard. For nine years Fran served on the MCDHH Advisory Board. During this time she also provided consultative services to the MRC, assisting the HCAP department in hiring a case manager and volunteering for MRC for long-term special projects.

"With continued help from the MRC Home Care program, I plan to stay involved with issues in the Boston community for another 25 years" says Fran emphatically. And we believe she will!

Mind Over Matter

Listening to Joan Smith talk passionately about the Multicultural Recreation Grant at the Massachusetts Rehabilitation Commission is to hear about a program she claims is the "ultimate success story for MRC." Joan is a program coordinator in the MRC Statewide Head Injury Program (SHIP) and oversees a staff of three coordinating the Recreation Grant. Joan insists her role is simply monitoring the grant project, since the true success of the program, which has been serving persons with Traumatic Brain Injury (TBI) from the Chinese community, is derived from its consumers.

In 2000, MRC-SHIP secured a 3-year federal grant to implement a Traumatic Brain Injury Multicultural Outreach Project serving diverse populations. This grant allowed MRC-SHIP to hire outreach workers from different ethnic backgrounds and educate them about TBI so they could, in turn, educate community members and providers about this particular disability. Outreach workers cultivated relationships in their own ethnic communities, allowing MRC-SHIP staff to be accepted. "Previously, we had provided outreach to a number of communities with varying degrees of success," said Joan.

The Multicultural Recreation Grant, an offshoot of the original Outreach Project, began in 2001 to teach functional living skills through recreational and leisure activities. The Grant serves approximately 70 consumers and family members annually. One of the remarkable spin-offs of the Grant is the Memory Studio, created by Grant staffer Man Yung ("Yo-Yo") Yau and a consumer who is a photographer. "The goal of Memory Studio was to assist consumers to see the world with new eyes through the use of photography," Joan said. Thus, each picture taken by an MRC consumer captures their unique feeling of the world.

Memory Studio begins with a personality interview to better understand what a consumer's character is like and then follows with training on the use of cameras in such topics as light, color, using filters and more. Consumers practiced communication skills, problem solving, time management, computer skills, telephone usage and even received travel training in both individual and group sessions as well. The Project also assisted consumers with keeping a personal journal, another avenue of self-discovery.

One consumer who participated in the Memory Studio has a degree in computer science and established a website so the larger community can easily view their works of art. Another consumer is an 80 year-old man who has a new lease on life since participating. He sends copies of photographs to his family in China via the Internet. His photo shoots mostly occur in the Boston Common, focusing primarily on the beauty of the changing seasons, taking pictures of birds, dogs and squirrels. He began learning to speak English and how to use a computer at the age of 70. He now speaks to other elders about finding something to do to liven up their lives, and tries, often successfully, to spark some of them into becoming more active. "The program benefits consumers in ways, including bringing out latent photography talents they didn't know they possessed," Joan explained.

Photographs taken as a part of this project have been made into greeting cards and framed art, many of which have been sold. Some pieces were donated to the WGBH Auction held last summer. Consumers had poster presentations and a table to sell the greeting cards and framed artwork at the Massachusetts Brain Injury Association Conference and Mass-APSE Conference in 2004. Greeting cards can be found in stores in Cambridge and Provincetown, Massachusetts.

Monies generated by the sales even helped to start a business. Two consumers opened a bank account to pool their resources and buy equipment instead of keeping their earnings for individual monetary gain. "The program turned out very different than we expected. We never knew the consumers had these abilities," Joan said. Another product of the program will be a CD put to music with biographies of the artists, showing all their works of art. Memory Studio scheduled an exhibition of the project in the Fall at Malden Access TV as well.

Persons living with TBI are finding ways to better manage their disability. One consumer for example, has severe headaches causing decreased mobility moving her head and neck. She figured out how to use a mirror and take photos at dawn or dusk so the sun would not be a factor in her headaches. The consumers have become a close-knit community. "If somebody doesn't show up for classes they're calling and looking for that person," Joan said. For a TBI consumer, that sort of alertness is essential in moving forward despite their disability.

Nobody knows better than the consumers what will work for each of them. The most glaring success of the project is that these participants are not merely surviving, they are thriving.

Stavros Independent Living Center

Stavros is one of the state's 11 Independent Living Centers (ILC's) serving people with disabilities in Hampden, Hampshire and Franklin counties, since 1973. Independent Living Centers provide community advocacy and seek to eliminate attitudinal, architectural, social and economic barriers for people with disabilities. ILC's also provide direct services to individuals with a variety of disabilities, offering a broad range of community-based services for consumers of all ages. Some of its direct services include peer counseling, housing assistance, self-advocacy training, services for the Deaf and Hard of Hearing and independent living skills training.

Stavros serves approximately 4,000 consumers annually and is headquartered in Amherst, with satellite offices in Greenfield and Springfield. Stavros also has a Personal Care Assistance Program.

Rick Malley has worked for eight years as a Systems Advocate at the Stavros satellite office in Greenfield. The 43-year-old Malley is married, lives in Greenfield, and believes his familiarity with the communities he serves is important to its residents with disabilities. "People in Franklin County tend to be wary of outsiders. So, my being a resident allows me to be more effective with the consumers," Rick said.

Historically, citizens with disabilities in the Commonwealth's rural areas have been underserved relative to community-based supports and services. Stavros and its staff have brought awareness of the plight of people with disabilities in the region by cultivating positive working relationships with local, state and federal officials. Greenfield Mayor Christine Forgey considers Rick an asset on disability issues. "Greenfield is fortunate to benefit from the determination Rick brings to everything he tackles. Rick's unique perspective and keen insight affords us the opportunity to plan pro-actively during the early stages of project development for the rights of all citizens to equal access."

Rick knows that his tireless work on behalf of persons with disabilities is the right thing to do and his affinity for doing so results from sharing common ground with them. He has X-Link Retinal Schesis, an eye disease so rare that it affects only 500 people worldwide. Rick is legally blind and slowly losing the remainder of his vision. He explains that the term "legally blind" means vision cannot be corrected and that the best vision in the "better eye" is 2200, which means a person with 20-20 vision can see an object clearly from 200 feet, while the person who is legally blind needs to be 20 feet in front of the object to see it.

While serving in the Army in 1979, Rick's eye disease was diagnosed. After being honorably discharged, he worked the next decade in a Greenfield manufacturing plant fixing machinery. But as his vision worsened Rick would lose his job.

Enter the Massachusetts Rehabilitation Commission (MRC). They provided Rick a new outlook and promised that getting a job was a realistic goal. "MRC gets people with disabilities working so they can feel like people who view their lives as having opportunities to succeed," Rick said.

The MRC-VR Holyoke office assisted Rick in attending Holyoke Community College where he earned a degree in business management. He later attended U-Mass Amherst, and his case was then turned over to the Massachusetts Commission for the Blind. While Rick believes this move wasn't necessary, it is required by law to do so. He is the first in his family to graduate from college.

While studying at Holyoke Community College, Rick's firebrand advocacy got him labeled a "trouble maker" for advocating aggressively for students with disabilities. But his MRC-VR Counselor, Keith Ford, encouraged his advocacy for change. "Keith was supportive of everything I wanted to do," Rick adds. "Keith was instrumental in my becoming the advocate I am today in pushing the disability rights agenda." While a consumer of the MRC, Rick won a Certificate of Special Congressional Recognition by Rep. John Olver (D-Amherst), who is a co-sponsor of MiCASSA, for his advocacy on disability issues. After graduating, Rick landed a job at Stavros because of his advocacy at Holyoke Community College.

Rick follows in the footsteps of the disability rights activists who helped to get Stavros off the ground in the 1970's. For example, he advises several municipalities how to spend Community Development Block Grant funding on access for people with disabilities. Like other Stavros employees, he provides outreach to legislators, civic groups and colleges. Rick also worked with the Town of Shelburne Falls to make its downtown businesses accessible.

Today, Rick chairs the Town of Greenfield Commission on Disability Access. In this capacity, he has paved the way for greater access for many consumers of the MRC-VR Greenfield Area office, located right around the corner from the Stavros office where Rick works. He is a member of the Disability Policy Consortium and also serves on the Consumer Planning and Implementation Group, which provides input on establishing federally funded grants for persons with disabilities.

"Working at an ILC (Stavros) has helped me learn how vital its services for consumers are and also for myself," Rick said. The citizens with disabilities in the rural reaches of western Massachusetts can be assured that a handful of people are acting on their behalf, advocating for essential services, and ultimately working tirelessly to improve their life situations.

Included in that handful is Rick Malley.


Looking Forward to Going Home

When consumers, their families and advocates discuss community-based supports and services as an alternative to living in institutions, they need search no further than the Massachusetts Rehabilitation Commission's Nursing Facility Transition Project. This project is staffed by an "interdisciplinary" team of MRC specialists, including Supervisor Beth Williams of the Statewide Head Injury Program, Cindy Wentz of the Independent Living Program, Dr. Francesca LaVecchia, MRC's Chief Neuropsychologist, and two seasoned case managers, Mary Adams and Jay Herzog. This team provides the planning, services and supports necessary for long-term stability for individuals who wish to leave the nursing home for life in the community.

In 2004, the MRC was able to assist 15 individuals with developmental disabilities leave long-term care facilities to pursue a life back in the community, bringing the total to 70 since 1999. Although this number may seem small at first glance, the significance is enormous in that it represents previously unimagined opportunities for 70 people to attain the dream of living independently.

Individuals with disabilities end up in institutional settings for a variety of reasons. Some may have lived with parents who passed away or who could no longer care for them due to advancing age; others may have owned their own homes but did not have the supports necessary to continue living independently; some may have been hospitalized for medical reasons for extended periods of time and lost their housing situations in the interim; still others may have been institutionalized at birth because their families felt it would be the safest place for them, where they would have all of their needs met. "Unfortunately, some individuals with developmental disabilities, now in their 50's and 60's, have lived in these institutions for over forty years," recalls Cindy.

This Project originated from a class action settlement on behalf of people with mental retardation and developmental disabilities. The settlement with class members was reached in 1999 with the agreement to place up to 1,175 people into the community from institutions over a seven-year period. Member agencies participating in this endeavor are the Massachusetts Rehabilitation Commission, the Department of Mental Retardation and the Division of Medical Assistance. Funding is allocated from the state Legislature. The MRC is charged with serving consumers with developmental disabilities, which includes brain injuries, neurological disorders and physical disabilities such as cerebral palsy.

People with developmental disabilities often need a combination of special services, support and other assistance that is likely to continue on an indefinite basis. Such individuals constitute a part of the underserved population of people with disabilities in the Commonwealth. Although the exact number is unknown, it is estimated that more than 108,000 Massachusetts residents have some type of developmental disability.

Working within the financial constraints of the settlement, the MRC is unable to place all consumers who wish to transition out of an institution. Instead, the agency must decide each case separately according to a consumer's motivation, medical and functional stability, and their ability to accept and participate in services. Once a decision is made to work toward placement in the community, the MRC case manager works with the consumer to identify service needs and engage with a provider who will provide ongoing support. Some consumers need immediate assistance with locating affordable and accessible housing, obtaining home furnishings, durable medical equipment and assistive technology. Often consumers receive assistance with financial management and benefits planning, managing their PCA, and if they are so inclined vocational/day services, skills training, advocacy and finding transportation and medical/clinical resources.
Beth is proud of supervising a program offering such meaningful opportunities for individuals who can thrive with the proper supports. "I'm part of an effort to give chances to people who may never have had them before. You can see how it can make a huge impact in somebody's life to be offered different scenarios for considering leaving the nursing facility," Beth said.

The Nursing Facility Transition Project (NFTP) strives to offer individuals choices from an array of models for receiving supports in the community. These models include supported living (about one-third of MRC placements), case management, congregate housing, assisted living, home shares, and 24-hour staffed settings. In all situations, consumers are given the choice regarding their living options and treated with the respect they deserve.

A "developmental disability," as defined in federal law, is a severe, chronic, often lifelong disability that causes substantial limitations in several major life activities such as self-care, receptive and expressive language, learning, mobility, self-direction, the capacity for independent living, and economic self-sufficiency. It is attributable to a mental, emotional, sensory and/or physical impairment that is apparent before the age of twenty-two.

Supporting Youth In Transition

The Massachusetts Rehabilitation Commission has made a major commitment to serving high school students with disabilities through various outreach programs and services that deal with transition to adulthood. We all know that high school graduation is a major event in everyone's life. It can be an exciting time both filled with promise and anxiety. Many questions are usually racing through an adolescent's mind, especially if they have had a severe disability and have relied on others for support and guidance. Should I go to college or should I work for a while? What kinds of jobs can I handle? Can I survive on my own if I leave home? Who can help me and what services are available to me? These and many other questions surrounding a youth's transition to adulthood can be extremely overwhelming.

In 1986, the Massachusetts Rehabilitation Commission (MRC) established its Turning 22 (T-22) Program. This program serves special education students who wish to pursue independent living when they leave high school. In order to be eligible, a student must have a mobility impairment, in addition to a psychological, cognitive or emotional disability. The MRC begins involvement when a "688 referral" is made by the high school's Special Education Department. Chapter 688 is the state law that provides a two year transitional planning process from school to work and community life for students with significant disabilities. Hopefully, this referral is made at least two years prior to graduation or to the student reaching the age of 22.

That's where the MRC Transition Team steps in, responsible for determining eligibility and providing statewide coordination of the Chapter 688 process. Once a student is determined eligible, the T-22 Services Coordinator will attend Individual Education Plan (IEP) meetings to suggest ways the school can best prepare the student for living independently. During the last year of school, the MRC convenes a meeting to develop an Individual Transition Plan (ITP). This plan will identify all of the independent living and vocational rehabilitation supports needed and define what agency will meet each need.

If it is determined that a consumer will need a case coordinator to provide assistance with finding suitable housing and later with managing the PCA program, their finances, and general organizational needs, the individual is asked to choose one from among seven approved agencies to provide these supports. The frequency of provider visits is based on consumer need and requires prior agreement between the consumer and the Case Coordinator. This type of independent living support is referred to as Supported Living and will be provided as long as is necessary. In addition to regular visits, each provider agency can be contacted at any time and on any day in case of emergencies. Presently the T-22 program is providing supported living services to 45 consumers with a range of disabilities. The case coordination each consumer is receiving has made it possible for them to lead independent lives in their own homes with the safety net they require.

The T-22 program owes much of its success to Program Coordinator, Jim Durant. Jim, a former consumer of MRC Services, has a wealth of experience and breadth of knowledge on issues impacting persons with disabilities. This can be attributed to years of working and advocating successfully within the social services and health care systems throughout his entire life. Living with a disability since birth, Jim has seen many changes in the service delivery system during the past few decades.

Thinking back, Jim wishes a program such as this existed when he was graduating from school. Because there were no options at that time, he spent several years living in nursing homes. Jim has a strong interest in keeping T-22 a viable and vibrant MRC program. "The Turning 22 program gives hope to consumers who otherwise would have none," says Durant.

The MRC Transition Team provides training and technical assistance to MRC staff regarding transition planning for students who are leaving high school and are in need of services when they graduate or turn 22. Team members also provide case management services for all non-VR eligible consumers assigned to the MRC by the Bureau of Transitional Planning (BTP). The Team is currently composed of three staff: Jane Buckley, Transition Team Supervisor, who has worked in the field of special education as a teacher, coordinator and principal for many years, and also worked for the Departments of Education and Mental Retardation; Joy McMahon, Statewide Transition Coordinator, who has worked on transition activities at MRC since 1993 and was part of the Massachusetts Transition Initiative, a 5-year grant funded by the US Department of Education; and April Maselli, Chapter 688 Eligibility Coordinator, who had previously served as Chairperson of the State Rehabilitation Council and now determines Chapter 688 eligibility for students referred by the MRC and other adult service agencies. Jane Buckley also serves as the MRC representative on the BTP Transitional Advisory Committee (TAC), which is comprised of representatives of all involved state agencies.

The Transition Team also provides training regarding the federal transition requirements under the Individuals with Disabilities Education Act (IDEA) and the Rehabilitation Act. The Team works closely with the Massachusetts Department of Education (DOE) to improve the linkages between the MRC and the local school systems. Predominantly involved in activities on the state level, the Team tries to foster interagency collaboration to develop more coordinated and comprehensive services for transition-age youth and identification of best practices at the local level through the Regional Transition Teams now active in the Boston, Central, and Western regions of Massachusetts.

The department has also tried to improve post-school outcomes for transitioning students through participation in the Massachusetts Partnership for Youth in Employment grant.

MRC STATE REHABILITATION COUNCIL

The mission of the MRC State Rehabilitation Council (SRC) 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 (except those with blindness) 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 MRC State Rehabilitation Council are volunteers who donate their time to fulfill the mission of the SRC.

MRC STATE REHABILITATION COUNCIL

Appointees
Zary Amirhosseini, S. Boston
David Kaiser, Northboro
Mary Moore, Salem
John Beach, Hyannis
Betty J. King, Boston
Mark Murphy, Dartmouth
Janet Dale, Milford
Barbara Lybarger, Boston
Patricia Sheely, Pittsfield
William Doherty, Arlington
Warren Magee, Dorchester
Antonia Torres, Holyoke
Toby Fisher, Woburn
William McCarriston, Avon
Karin Williams, Boston
Brooke Heraty, Boston
Kimberly McLaughlin, Canton
Charles Vernon, Brookline
Sandra Houghton, Quincy
Oswald Mondejar, Boston

Ex-Officio Members
Andrea Bader, Boston
Karen LaChapelle, Southampton
Stephen Reynolds, Gloucester
Kathleen Cardin, N. Westport
Hang Lee, Milton
Mary Esther Rohman, Boston
Owen Doonan, Duxbury
Lisa Matrundola, Boston
Maria Rosa, Holyoke
Suzanne Doswell, Pittsfield
Kathy Mooney, Salem
Angelica Sawyer, Cambridge
Anne P. Guterman, West Newton
David Mortimer, Sudbury
Hartmut Teuber, Arlington Heights
Inta Hall, Hingham
Ann Marie Paulson, Lakeville
Francis Verville, Fall River
James Hanna, Roxbury
Ventura Pereira, North Dartmouth
Dwight Woodworth, Worcester
Stephen Holochuck, Brighton
Carol Perlino, Lynn
Pam Wool, Newbury
Keith Jones, Somerville
Katherine Piccard, Charlestown

Community Services Program Facts and Figures FY '04

IL Center Services

Total

Number of consumers who received services

10,184

Number of information and referral calls

14,064

$ Expended

$4,468,194

Turning 22 Services

Number of consumers who received services

107

Number of consumers in Supported Living

51

Number of new Individual Transition Plans

7

Number of new referrals

9

$ Expended

$2,323,767

IL Assistive Technology

Number of consumers who received services

261

Number of consumers on the waiting list

75

$ Expended

$836,689

Housing Registry

Number of new listings

140

Number of vacancies

522

Number "hits" on Mass Access website

18,540

$ Expended

$83,754

Supported Living Services

Number of consumers who received services

100

Number of consumers on waiting list

21

$ Expended

$786,795

Home Care Assistance

Total

Number of consumers served

1,818

Number of new cases opened

433

Number of hours of services provided

233,596

$ Expended

$5,135,847

Protective Services

Number of consumers who received services

183

Number of new service plans

126

Number of consumers provided paid services

186

Number of investigations

251

$ Expended

$572,710

Head Injury Services

Total

Number of consumers who received services

597

Number of new applicants

257

Number of services purchased for consumers

690

$ Expended

$11,612,643

DISABILITY DETERMINATION SERVICES OVERVIEW

Every state in the USA operates a Disability Determination Services (DDS) program responsible for providing medical/vocational decisions on behalf of those making application for Social Security Disability and/or Supplementary Security Income benefits. Last year, the Massachusetts DDS processed a total of 84,948 cases which represents an increase of approximately 3000 cases from the previous year. The Social Security Administration measures the performance of all DDS's annually and the MRC-DDS continues it's leadership role as one of the most productive in the nation. This translates to quicker decisions for residents of Massachusetts with disabilities making application. Our decisions are provided, on average, 20 days faster than the national average.

The MRC-DDS continues to provide innovative service delivery to the most vulnerable populations. There are DDS staff with special training who provide services to the homeless population as well as those with HIV. Our Homeless Initiative has recently won national recognition.

The MRC-DDS also continues to provide much needed service to the entire SSA New England Region. We have provided casework assistance to other states in the region, provided the SSA Regional Office with program staff and participated in a federal initiative focusing on fraud in the application process.

The Commonwealth of Massachusetts reaps tremendous benefit from the services provided by the MRC-DDS. In many cases, the awarding of benefits is the first step towards increased independence. It allows some individuals to move from homelessness to housing. In other cases, it allows those with disabilities to concentrate on vocational rehabilitation services and return to productive work.


E ntering an Electronic World

Within all state bureaucracies there's at least one person responsible for ensuring that the right thing is done. It is a critical role since the lives of thousands of people depend on the myriad programs and services to be available when they most need them.

Nowhere is that portrayal more accurate than at the Disability Determination Services (DDS), a program administered by the Massachusetts Rehabilitation Commission (MRC). And one of the people responsible for the daily grind of the department serving the most people at the MRC is DDS Assistant Commissioner John Reilly.

The MRC-DDS is responsible for providing medical/vocational decisions on behalf of people with disabilities making application for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. In 2002, an ambitious initiative was begun to move from a "paper heavy" disability adjudication process to an "electronic disability process" (Edib), resulting in a completely "electronic folder" (EF). This Social Security Administration "paperless" initiative eliminates waste, saves time, energy and money. As John says, "A lot of paper has been required to document our decisions. Usually, an application begins as only about two pieces of paper, but by the time it leaves the DDS to go to the Social Security Administration, the file is three inches thick." The "paper heavy" determination process consisted of paper documents gathered at each stage of the claim, such as applications, medical records, etc. Over time, the files became thick and significant costs were incurred to store, maintain and transport them.

It is no wonder that Reilly has become a big fan of the Edib effort. Not only will it save lots of paper, it will also save staff hours. The advantage of Edib is that the SSA hopes to achieve considerable savings in postage costs and storing files in secure facilities. In April 2005, the MRC-DDS will start the process to convert completely to an EF process. You can learn more about Edib from the SSA website, by visiting www.ssa.gov.

Through the new Edib process, all paper records from hospitals and/or doctors are sent to a regional scanning center where they are converted into electronic documents. These documents are then forwarded electronically to the MRC-DDS, eliminating the need for storage space while at the same time making retrieval of records almost instantaneous. It should also serve to speed up the decision-making process.

"We help people with disabilities remain independent. Sometimes SSI or SSDI is their only source of income. We keep in mind that consumers have experienced a traumatic or dramatic life-changing situation. Many of these people have worked all their lives and still must pay bills, a mortgage, and buy food. Behind each of these files is a real person. They're depending on Social Security for their survival," explains John.

For years the MRC-DDS has been a national leader in terms of productivity and innovative projects, such as their HIV and Homeless specialty units. Through the Edib initiative, the MRC-DDS will ensure they maintain their distinction, translating into better service for their many consumers. The result of this new paperless system? Providing applicants with disabilities with faster claims processing and higher quality service.

John explains that claimants are under 65 years-old and cannot work because of a disabling situation. "We apply the Social Security Administration regulations to each applicant to make a decision about their eligibility. Also, the Social Security Administration periodically sends us the case file of everyone who receives benefits to see whether there has been any medical improvement." Reviews are conducted annually and then every third and seventh year. All work comes exclusively from the Social Security Administration and is kept strictly confidential.

John supervises two Regional Directors who manage 14 Case Processing Units that handle claims for Social Security Disability benefits. He has additional duties as well, since he also oversees the Hearings Unit and the Quality Assurance Unit, comprising a total staff of 160 in the Boston office. The MRC-DDS serves more than 84,000 claimants annually.

John started his 30-year career with the MRC as a Junior Vocational Rehabilitation Counselor in the Lawrence VR office. He was later promoted to Unit Supervisor and then worked in the Northeast Regional VR office. Eventually, he became the first director of MRC's Independent Living Program in 1980. Since 1987, he's been Assistant Commissioner of the Boston MRC-DDS. So, the next time you think of MRC, remember the vital work the MRC-DDS is daily doing on behalf of people who experience a life-changing event that may be temporary or permanent. And that help is waiting to be tapped into.


The Benefits of Collaboration

An essential function within the Disability Determination Services (DDS) is the Disability Hearings and Adjudication Officer Units (DH/AO Units). It is a place teeming with activity, a devoted and savvy staff of 23, and they're saving the federal and state government millions of dollars. Why? Because they form part of the Cooperative Disability Investigations Unit (CDIU) which investigates Social Security fraud, under the watchful eye of Tom Collins, manager of the DH and AO Units. The CDIU is an interagency collaborative effort involving the Office of Inspector General, the Social Security Administration, the Massachusetts Attorney General's office and the MRC-DDS.

Two of Collins' staff members work with the CDIU to assist in conducting investigations into potential fraud and abuse by Social Security Disability claimants. The team works with the Office of Inspector General, investigating 12 to 15 cases each month. "These are typically people trying to get benefits who do not really have a disability. There is a substantial savings to Massachusetts and the Social Security Administration," Collins explains. The savings in August 2004, for example, was $540,000. The year to date savings to Social Security for FY 2004 was a staggering $3.3 million.

Collins' primary role is two-fold: he supervises three doctors, three administrative hearing assistants, one Senior Vocational Disability Examiner, as well as nine Disability Hearings Officers (DHO). The DHO's hold face to face hearings regarding appeals of a claimant's Continuing Disability Review (CDR) status. Thus, this team helps to ensure that those who continue to receive disability benefits deserve to do so.

Collins' secondary role is to oversee the Adjudication Officer Unit with a staff of seven. They handle key agency initiatives and pilot projects. This Unit has been involved in processing other state's disability cases and was the first to handle claims from Vermont, Rhode Island, Connecticut and New Hampshire.

Another new initiative Collins is involved with is the Outreach and Support project at the Woods Mullen Homeless Shelter and Long Island Shelter, assisting homeless persons with disabilities apply for Social Security Disability benefits. This program was built on the successes of the Homeless Unit operating out of the Boston DDS office under the guidance of Clare Deucher. "Our role has always been to make the application process of the Social Security Disability Program as comfortable as possible for homeless people," comments Clare. This new project operates under the same DDS service philosophy where individuals are treated with compassion and respect."

This new outreach program is actually a cooperative alliance between DDS-DH/AO staff, the Department of Transitional Services, Woods Mullen and Long Island Shelter personnel and the SSA. The pilot's venture is intended to assist some of the most disadvantaged citizens during the development and decision-making part of their SSI disability claims. Both Woods Mullen and Long Island Homeless Shelters are located in the Boston area and Edith Jacobs, a DDS Review Examiner, visits there one day per week.

The Homeless Unit at the Boston DDS received a new national distinction in 2004. The STAR award (Solutions Through Alternative Remedies) was bestowed upon the Homeless Unit in February 2004 by the National Law Center for Homelessness and Poverty, headquartered in Washington, DC. This award is given to agencies that have creative programs with new initiatives that are successful in helping homeless individuals. The DDS Homeless Unit earned the STAR award because it continues to develop innovative and effective programs that are responsive to the needs of homeless individuals.

"Every homeless person has a unique story," explains Clare. "Many people are forced into homelessness because rents are so high in Boston and surrounding areas that it's nearly impossible to rent even a studio apartment." Clare cautions that while life may look good to each of us today, a major life-changing event could turn everything upside down for virtually anybody. "People like to believe their lives are stable, but all it takes is a major economic crisis in their lives to render somebody homeless."

Collins harbors great admiration for both the staff he supervises and for those in the Homeless Unit and heaps high praise on the job they're doing daily. "This group brings the highest standard of service to citizens with disabilities in the Commonwealth. Their work has helped protect the integrity of the Social Security Disability program, while ensuring benefits are getting to those most in need."

Disability Determination Services Advisory Committee

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.

Disability Determination Services Advisory Committee

Sarah Anderson, Boston
St. Francis House Director, Boston
Betty J. King, Boston
Gail Havelick, Boston
Chris Czernik, Lynn
Barbara Seigel, Boston
Linda Landry, Esq., Boston
Emily Herzig, Lynn
Shirley Dopson, Jamaica Plain
Joanne Shulman, Framingham
Kathy Mooney, Salem
Augustine Ugbolve, Jamaica Plain
Taramattie Doucette, Boston
Francis Verville, Fall River

Disability Determination Services Program Facts and Figures FY '04

Total Receipt of Cases:

83,136

Total Dispositions of Cases:

84,948

Initial Claims Filed:

52,056

% Allowed:

44.5%

CDR Receipts:

15,276

CDR Dispositions:

16,813

Consultative Examinations Purchased:

22,964

Consultative Examination Rate:

27%

Medical Evidence of Record Purchased:

59,663

Medical Evidence of Record Rate:

70.2%

Total Medical Costs:

$6,608,130

Total Budget:

$33,323,148

Cost Per Case:

$392

Accuracy of Decisions:

95%

Total MA Population:

6.4M

Customer Services

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 consumers and MRC staff to find a solution. If this type of intervention does not bring about resolution, a formal appeal process and mediation is also available to VR consumers, both handled by the agency's Appeals Coordinator.

The Ombudsperson assists consumers across all service programs and may be contacted by telephone at (617) 2043603 or 18002456543 (voice and TTY), through the agency website at www.mass.gov/mrc or by writing the MRC Administrative Office in Boston. The Appeals Coordinator may be contacted by telephone at (617) 204-3602 or 1-800-245-6543 (Voice and TTY) or by writing the MRC Administrative Office in Boston.


In Memoriam - Mike Warshawsky

Mike Warshawsky survived a life-changing event in the summer of 1971 when he sustained a high-level spinal cord injury, shattering his plans to become a physician. Funding from the MRC-VR Lowell office to return to college and hire personal care attendants sent him on the path toward earning an engineering degree from Tufts. Mike enjoyed a 21 year career at Raytheon, capping it off as a systems engineer who worked on the Patriot Missile. Mike actively advocated on behalf of people with disabilities, whether for architectural building accessibility, PCA programs, or with pharmaceutical executives to provide safer drugs. He founded the Andover Commission on Disabilities and most recently served on the Cambridge Commission for Persons with Disabilities.

When Raytheon official Paul Weeks met Mike Warshawsky in 1996, he had never before worked with a person with a disability. Yet his inexperience did not interfere with the way he interacted with Mike. "Mike's work ethic was as high as anyone who works here. He upheld the highest standards of anybody I know...and he always got the job done under budget," Paul said.

"The biggest thing that struck me about Mike was his need to be treated like everybody else," Paul said. Mike will always be remembered as the catalyst for this very long standing MRC/Raytheon partnership. And that's the prevailing attitude Raytheon has taken in its relationship with the Massachusetts Rehabilitation Commission.

MITT ROMNEY
Governor

KERRY HEALEY
Lieutenant Governor

RONALD PRESTON
Secretary
Executive Office of Health and Human Services

ELMER C. BARTELS
Commissioner of Rehabilitation

THE MASSACHUSETTS REHABILITATION COMMISSION
Administrative Offices
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)
www.mass.gov/mrc

This document is available in alternative formats upon request.


This information is provided by the Massachusetts Rehabilitation Commission.