Massachusetts Rehabilitation Commission Mission Statement

The vision of the 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

Table of Contents

A Message from Commissioner Bartels
Customer Services
VR Vocational Rehabilitation Services (VRS) Overview
VR A Win-Win for Company and Consumer (Carlos Perez)
VR Creating Small Business Opportunities (Ted Hinman, Heather Crosby,
and Steve Amarello)
VR Energy and Persistence (Barbara Aucoin)
VR Someone to Count on (Joe Provost)
VR In the Driver's Seat (Maura Cabrera)
VR The Course to a New Life (Paul Shattuck)
VR Vocational Rehabilitation Services Facts and Figures FY '05
State Rehabilitation Council
CS Community Services (CS) Overview
CS The Tools to Help Others (Gigi Ranno)
CS Part of the Community (Ad Lib Center)
CS Always On Call (Alyse Bukoski)
CS A Valuable Addition to the Team (Eric Shamus)
CS The Road to Independence (Jim Viggiano and Kathleen Eid)
CS Community Services Facts and Figures FY '05
DDS Disability Determination Services (DDS) Overview
DDS A Job Well Done (Kristine Robbins)
DDS Disability Determination Services Facts and Figures FY '05
DDS DDS Advisory Council Members
MRC State Funded Services
MRC Federal Funded Services

A Message from Commissioner Bartels

Dear Colleague:

I am pleased to present the Massachusetts Rehabilitation Commission's 2005 Annual Report which illustrates the importance of collaboration in our work. This report shares the stories of several consumers who have benefited from our services, as well as from the partnerships the Commission has built with other government agencies, non-profits, and the private sector. As you will read, the MRC provides a wide range of services and last year helped approximately 100,000 people with disabilities further their education, find employment and live independently.

As an example, our pilot program with Good News Garage made available 30 refurbished vehicles to enable people with disabilities to drive to work. The program was so successful that it is being expanded to help 40 consumers next year. Our inter-agency relationships with Elder Affairs and the Departments of Mental Health and Social Services have been critical to our Protective Services Department, charged with ensuring consumers are safe and being treated appropriately by their caregivers. As always, we continue to work hand-in-hand with the business community in localities across the state to help consumers launch their careers.

The MRC has become an integral part of the disability community. I am proud to be a part of this invaluable network and particularly grateful to the MRC staff who are so committed to their work and our constituents.

Thank you for taking the time to read this report to learn about our work and the difference we are making every day. I look forward to another year of building partnerships and working to meet the needs of the people with disabilities we serve.

Elmer C. Bartels, Commissioner

Customer Services

The MRC has two staff members working within the Commissioner's Office in the agency's Customer Relations Department who report directly to the MRC Chief of Staff. 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, other state government personnel and MRC staff members.

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, there is a formal appeal process and mediation also available to MRC-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) 204-3603 or (800) 245-6543 (voice and TTY), through the agency web site 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 (800) 245-6543 (voice and TTY) or by writing the MRC Administrative Office in Boston.

Vocational Rehabilitation Services Overview

The Public Vocational Rehabilitation Services (VRS) Program of the Massachusetts Rehabilitation Commission receives close to 80 percent 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 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, with advances in public policy 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 2005, the MRC-VRS Program helped more than 3,400 people with disabilities enter the workforce, collectively earning more than $55M in their first year of employment. With an average wage of approximately $11 per hour, these employees paid $12M in taxes to the Massachusetts and federal government treasuries.

Federal funding continues to be a challenge in placing consumers seeking to work in a competitive environment. The MRC-VRS Program continues to operate under an Order of Selection system where services are provided only to those with the most significant disabilities. Since FY 2002, the VRS Program has operated with a wait list; FY 2005 ended with a rolling wait list of only three months. This will result in more people with disabilities being able to enter employment in the months and, hopefully, years ahead.

In accordance with Section 105(c) of the Rehabilitation Act, the VRS Program has a very active State Rehabilitation Council (see page 21). This past year, more than 20 gubernatorial appointees served on the Council and provided guidance to staff working in all areas of the Vocational Rehabilitation Services Program.

A Win-Win for Company and Consumer

I want to go to work. I want a job." Carlos Perez, a VR consumer with hereditary familial spastic paraparesis, was determined to contribute financially to his family. Carlos' condition affects both lower legs with increased tendon reflexes and spasms in his leg muscles. Carlos went through numerous corrective surgeries during his childhood along with intensive physical therapy. Carlos now walks with a scissored gait, but he has not let his disability prevent him from working and helping to support his family. He maintains a positive attitude and prides himself on his strong work ethic.

Carlos' great attitude has been apparent to all the VR staff he has encountered. While in high school, his first VR Counselor, Bob Kelly, suggested Carlos consider attending Quinsigamond Community College (QCC). After conducting a comprehensive assessment of Carlos' aptitude and interests he enrolled at QCC in a Manufacturing Technology Program.

While at QCC, Carlos had a work-study assignment in the school's print shop. After a very positive experience he decided that the print shop environment was the right place for him.

Upon completing the certificate program, Carlos met with Ellen Spencer, his MRC-VR Employment Specialist. He made it clear to Ellen that he had an interest in working in the printing industry.

Ellen, an experienced job placement specialist having been employed with the MRC since 1996, works with 30 to 40 consumers at a time. She quickly recognized Carlos' superb attitude, unfailing politeness, and determination. As Ellen had worked with several Staples stores in the Worcester area, she believed the company would be a good fit for Carlos. Ellen and Carlos filled out the extensive on-line job application together. She also helped Carlos with his resume and conducted a mock interview. Almost immediately, David Lavallee, the Assistant Store Manager at Staples in Shrewsbury, contacted Carlos about an opening in the store's Copy Center. Within a week Carlos was interviewed and hired. Ellen noted, "It was the fastest placement I ever had."

Carlos earns $8.50 per hour with benefits that include health insurance, 401K contributions with a company match, and stock options. What is also important to Carlos is that his weekly earnings are more than three times the amount he received from Supplemental Security Income (SSI).

As David Lavallee, his supervisor, stated, "Carlos performs all the same duties as any other employee with the occasional exception of lifting and carrying heavy boxes of paper. Carlos began as a part time employee working up to 35 hours a week. However, Carlos showed he was more than up to the job, and now regularly works between 38 and 40 hours a week." As Carlos' hours increased, so did his responsibilities. Within the Copy Center, Carlos does color copying, binding and UPS mailings. Carlos has also been trained to operate the cash registers and will fill in when the store gets busy.

Carlos is very grateful for all the support and assistance he has received from the MRC. "Without them I wouldn't have a job. Ms. Spencer really helped me out. I just wanted a job so I could help my family." According to Ellen, "Carlos is a great example of the importance of a positive attitude. He is outgoing, polite and always with a smile." Clearly these attributes have served Carlos well, especially in a retail environment where customer service is so important. Perhaps as importantly, Carlos is employed in an environment that is well suited to his work preferences, desires and aspirations.

Creating Small Business Opportunities

Starting your own business is never easy, and no one succeeds in business without support. In the past year, the Massachusetts Rehabilitation Commission has provided such support to dozens of people who have now met their goal of owning their own business.

Ted Hinman spent much of his working life being misunderstood and underappreciated. Ted has Asperger's syndrome, which as he puts it, "makes people think you're stupid." But Asperger's has nothing to do with intelligence. This neurobiological disorder is characterized by autistic-like behaviors and deficiencies in social and communication skills. Undiagnosed for most of his life, Ted spent 12 years working as a janitor at a company where he felt mistreated by his co-workers. Though capable and talented, he struggled to prove himself in an atmosphere where his Asperger's symptoms were viewed as incompetence.

Ted knew he was capable of more. With his lifelong interest in blacksmithing, he went back to school, graduating in 2000 from the Massachusetts College of Art with a major in sculpture. In 2002, with the help of his wife Armene, he sought the medical care he needed and was able to connect with the Massachusetts Rehabilitation Commission. He began doing more and more with his sculpting talents, making connections with other blacksmiths and earning money from his craft.

Wanting to be his own boss, but without the resources to make it happen, he came to the MRC Greenfield VR office in 2002. His counselor, Mike Tomasko, helped Ted secure funding enabling him to purchase the equipment he needed to have his own shop. Ted also took a business planning course through the Franklin Community Development Corporation.

Through the network Ted had developed with other blacksmiths, he became aware of the opportunity to become the resident blacksmith at the Historic Northampton Museum and Education Center, the position enables him to work at a pace he determines. Not only does he work in the shop creating tools and sculpture, he gives tours to visitors and teaches his craft to others through the local community colleges.

Ted offers an eight-week course for up to nine students at a time and one-week teen workshops. His wife Armene says he is a very patient teacher because his own experience with a disability has made him sensitive to other people's learning differences. Ted is always up-front about his disability, explaining, "You have to admit what you are or people will figure it out sooner or later." He received counseling from the MRC on managing his work income with his Supplemental Security Income so he can support himself. Finally putting his talents to good use, he has found the right fit in the workforce. He created his own opportunity with help from the MRC and is, as he puts it, "running my own show."

Heather Crosby, like Ted, crafted her own opportunity to fit her employment needs and desires. She created a job for herself that not only provides an income, but helps her manage and minimize her disability.

"I have always known I wanted to be my own boss," says Heather Crosby, who now owns her own fitness center, Liquid Movement Center. Born with juvenile osteoporosis, or rickets, Heather started having regular surgeries at the age of nine. After years of painful surgeries, Heather began looking for a way to better manage her disability on her own. A book about Pilates, and its founder, Joseph Pilates, set Heather on a path that helped her to both better manage her disability and find her calling in teaching Pilates to others.

In 2001, Heather contacted Brenda Clark, VR Counselor in the Quincy MRC office. They put together a plan for Heather to get the training and credentials she needed to be able to open her own Pilates studio. Initially, a lot of the work they did together was problem-solving and, over time, Brenda was able to guide Heather along the path toward achieving her goals.

The MRC also helped Heather to pay for the apprenticeship training she needed to become certified to teach Pilates. As Heather trained, she found that the exercises were continuing to improve her own mobility. Her excitement about her own progress fed her desire to share what she had learned with others.

"To be able to teach people to move from a place of freedom is very rewarding," Heather says of her work. "It is not just an exercise, but a way of life." Before Heather started Pilates her bones ached so badly she didn't even want to walk. Now she exercises every day and has a range of motion her doctors didn't think would ever be possible. It would take time for Heather to reach a point where she could make a living from her passion for exercise, but she was committed to making it work.

Heather first started her business teaching out of her living room, slowly building a clientele. When she found the space in Rockville Center in December of 2004, she was ready to expand her business and now has more than 20 regular students. She also shares the space with a belly dance instructor, a yoga instructor, and a massage therapist.

Heather has an obvious enthusiasm for what she does, but according to her VR Counselor Brenda Clark, when they first met, Heather was not the joyful, energetic woman she is now. "When she came in she was frightened and depressed; there were a lot of tears." Brenda says Heather underwent a transformation as she set and attained her goals. Now that she has transformed her own life, she seems eager to help others do the same. As Brenda says of Heather, "She is one of the most caring individuals I have ever worked with and she really knows her stuff."

Steve Amarello is also successfully self-employed with a job that enables him to rest when he needs to and be on his feet when he can. Steve was nearly killed in 1995 in an accident in which he was severely injured and ultimately lost his leg. Steve thought his disability would make it impossible to go back to the only job he knew. Since the age of 16, Steve had been in the thermal forming industry. Thermal forming, or the piece of it that Steve does, is the design and creation of aluminum molds that manufacturers use to form plastic packaging. It is a job that can be physically demanding, and Steve knew that if he was working for someone else, he simply would not be able to perform at the same level he could before his accident.

"Will I ever be able to keep a job? Can I find a place to work that will allow me to sit down?" Steve struggled to figure out how to utilize the skills he had spent his lifetime acquiring in an industry that had what seemed like insurmountable physical demands.

Steve spent years after the accident in rehabilitation for his injuries and when he could, learning the ins and outs of running a machine shop from his two brothers, who were in the same industry. He devoted two years to researching and creating a business plan, so by the time he contacted Elaine Mello, Vocational Rehabilitation Counselor at the New Bedford MRC office in 2003 he knew exactly what he wanted to do and how to do it. He just would need MRC's help.

Steve knew he could not yet work a 40-hour week and would need to rely on his Social Security Disability Insurance (SSDI) benefits as he started his business. Because of the existing Social Security Administration work incentives, Steve was able to continue to receive SSDI and health insurance while working part-time.

Steve took the initiative to do much of the work of starting a company on his own, tracking down the financial support to start his business, and securing equipment and space for his company, Amarello's Machining. Steve was able to count on Elaine's guidance and support. "Elaine held my hand through the whole thing. She was wonderful," Steve said of working with his VR Counselor.

One thing that has made Steve much more productive at his new job has been the laptop and specialized software the MRC purchased to help get his business off the ground. And since he is the one in charge and making the decisions for his company, he can take new work from customers at a pace he can manage. Steve also sees bigger and better things in his future. He anticipates that in the coming years he will be able to expand by purchasing more equipment, hopefully hiring an employee as his workload increases, and forego SSDI benefits altogether.

Successfully running your own business is a challenging proposition requiring hard work, vision, good business sense and an entrepreneurial spirit. These consumers, with the support of multiple resources and the Public Vocational Rehabilitation Program, deserve special praise for their accomplishments. They have gained control of their work lives and have empowered themselves.

Energy and Persistence

What am I going to do with the rest of my life?" Barbara Aucoin asked herself this question when she first heard about the Massachusetts Rehabilitation Commission in 2004. Barbara has bipolar disorder, a disability she believes made it hard for her to feel satisfied with her past jobs. Barbara very much wanted to be productive and in the workforce, though, since she loves working in a social environment and engaging with people.

When Barbara first arrived at the MRC Natick VR office, she hadn't worked in over a year and was afraid to get another job. Although she had never been fired from a job and considers herself a very reliable worker, she had trouble keeping jobs. The stress would overwhelm Barbara and she would leave in frustration.

Barbara came to the MRC looking for a part-time job that would involve less stress and less standing than her previous occupations, and she needed the assistance of a vocational rehabilitation counselor to help her determine what the right job would be. She had spent most of her career in retail jobs, which were both stressful and physically demanding. In order to find a job where she would not be on her feet all day, Barbara believed she would also need to learn some computer skills.

Barbara was ready for a career change, but to determine just what that change would be, she took advantage of the career decision-making seminar at the MRC Somerville VR office. This class not only provided insight about her strengths and abilities as well as the job market, but also was a source of support and was a social network for Barbara. After the seminar, Barbara decided to take a two-week computer class that taught her the basics of hardware, software, e-mail and MS Office applications.

Barbara and her VR Counselor, Jennifer Fike, met monthly as Barbara continued to receive tutoring in computers, counseling on her benefits and new job leads. Jen was continually impressed with Barbara's energy and persistence.

With a new level of confidence, her computer skills, and the resume that she and her VR counselor had put together, she had what she needed to find the right job. In January 2005, she landed the job she had been looking for at the Curves Fitness Center in her hometown of Waltham. She is a Clerk/Receptionist/Trainer making $9.00 an hour, with the added benefit of free membership at Curves. Not only is she making a good living and meeting people in her community, but she has lost weight and quit smoking too!

At Curves, Barbara greets customers and potential customers as they arrive and answers the phone. She demonstrates the equipment, responds to questions and is putting her newly acquired computer skills to use as well.

"I like people and I am a good communicator, so I enjoy this job. It is a slower pace than a lot of my other jobs. It is certainly the least stressful job I have ever had," Barbara says of working at Curves.

Barbara finds that she has a lot of independence in her job now and that is directly related to the lower stress level. She has the trust and confidence of her employer to make decisions and has more control in her work environment. She also has a set schedule that enables her to manage her time outside of work. In less than two years, with the help of the Commission and her VR Counselor, Barbara has been able to achieve every goal she set for herself when she first walked through the doors of the MRC.

Someone to Count On

When Joe Provost came to the MRC Plymouth VR office in 2000, he already had a job, but was at risk of losing it without the right equipment. Joe was born deaf and was now in need of a new hearing aid which could amplify speech to a level where he could hear well enough to work. The purchase of a hearing aid was the first paid service the MRC was able to provide for Joe, but it wouldn't be the last.

In an economy that has its ups and downs, Joe has at times gone up and down with it. After losing his assembly job in 2001 when the company, like many manufacturing companies in the state, had layoffs, he came back to the MRC to explore his options.

Joe was looking for a job where he could work independently and where his hearing loss would not be an issue. With the support of his family and the help of his Vocational Rehabilitation Counselor, Lise Memling, Joe came up with a plan for getting a new job.

Based on his experience in assembly and his desire for independent work, Joe decided that welding would be a logical next step in his career. In July of 2002, Joe started the Job Corp Program, funded by the U. S. Department of Labor. The one-year program gave Joe the skills he would need to pursue his chosen career. His MRC VR counselor helped Joe enroll in the program and provided interpreter services for the orientation period of the training so Joe would not fall behind in the lecture portions of the program.

Once Joe completed his training program, Patrick Legein, the MRC Job Placement Specialist for the Plymouth VR office, stepped in to get Joe back into the workforce. Patrick aggressively pursued welding jobs, and within a few months of the completion of the welding program, got Joe an interview with a local employer.

Joe got the job at Nu-Vacuum Systems and over the next year, gained valuable work experience and further developed his skills. He worked full-time, making $11 an hour and was an asset to the company. Of his job at Nu-Vacuum, Joe said, "I feel comfortable here and my co-workers treat me like everyone else."

Appreciative of how hard VR staff had worked to make this job possible for Joe, he spoke of what it meant to have the support and help of his VR counselor and job developer. "I've experienced the frustration and disappointment of rejection after applying for jobs on my own. The MRC helped me find this job and supplied an interpreter."

Though Joe's case was closed once he was thriving in his new job, he knew he could always count on the staff at the MRC Plymouth VR office when faced with another challenge.

Unfortunately, that challenge would come about a year after his placement at Nu-Vacuum when Joe was impacted by layoffs again. Joe came back to the MRC and Patrick got right to work on finding him another job. The next employer Joe started with wound up laying him off after only a month at work, but this was just another temporary setback. Patrick went back again and pursued a number of promising leads, ultimately helping Joe find himself in the enviable position of choosing between two good jobs.

Together, Joe and Patrick looked critically at his options and decided on the job that was closer to home. The new job at Ocean Works may wind up being the job Joe retires from someday, but if it isn't, he will know who to call for help and support in finding that next job.

I n the Driver's Seat

In parts of rural western Massachusetts, reliable transportation is an absolute necessity. Maura Cabrera, who struggles with bipolar disorder and anxiety, describes having a car as "essential to my well-being."

Maura found the Massachusetts Rehabilitation Commission through a friend she met at Alcoholics Anonymous. To manage her bipolar disorder and anxiety she had self-medicated with alcohol, but in 2003 she sought the help she needed to manage her disability in a healthy way.

Maura worked closely with her Vocational Rehabilitation Counselor Desiree Hopkins in the MRC Greenfield VR office. Together they put into place an effective treatment plan through Healthy Connections that included therapy and medication. Maura's hard work in treatment paid off as she developed more self-confidence and healthier ways of working which contributed to her eventual vocational success.

The missing piece was transportation. Maura had successfully worked as a teacher until her worsening disability forced her to give up her career. She was living in a rural town with limited public transportation. Things that other people take for granted, such as commuting to a job or doing an errand, became huge obstacles to her success. "I felt like I kept letting people down, myself mostly, missing school, missing appointments. I started isolating because you don't want to make a commitment you can't keep."

In April 2004, the MRC began a pilot project with Good News Garage (GNG) to provide options to consumers whose transportation issues were barriers to their success. Shortly thereafter, Maura was placed on the waiting list for a car from GNG, an affiliate of Lutheran Social Services of New England, which helps people obtain affordable and reliable transportation. GNG receives donated vehicles and either sells them at auction to support the program, or has the car inspected and repaired so it can be given to someone in need. Cars receive a 72 point inspection and on average get about $1,000 worth of repairs, with the goal for a consumer to receive a car that will pass the state inspection and be repair-free for a year to 18 months.

There is a waiting list for cars from GNG, but Maura didn't waste any time. While she waited, she continued to work with Desiree and took courses at the University of Massachusetts to become recertified to teach. In less than a year, in May of 2005, Maura got the news there was a car for her. Because she was able to drive a standard transmission, she jumped ahead on the list, getting her car sooner than expected.

"Maura is a classic example of somebody in need of transportation. The day she arrived to pick up her car, we had to go get her," said Bob Buckley, Director of the New Hampshire office of GNG. GNG staff picked Maura up in the pouring rain and brought her to her 2001 Honda Accord. Desiree was also there to share the happy moment. Maura was one of thirty people who received cars through the partnership between the Massachusetts Rehabilitation Commission and the Good News Garage that year.

Since then she has been able to work as a substitute teacher at six local elementary schools while she continued taking classes to become certified to teach again. Maura is also enjoying the independence that comes with greater mobility. No longer planning her days around infrequent bus schedules, she feels more in control of her life. With just a few credits remaining at school, she hopes to be teaching full-time again in the fall.

Maura is grateful to her counselor Desiree for all her support and encouragement. "At that desperate point, you need someone to show you your options and that's what Desiree did. I always know I can call and the support will be there, " Maura says of Desiree. Desiree gives Maura a lot of credit for taking action, seeking help and making the most of it. "It really is a partnership with Maura in the driver's seat. She has risen to the challenge at every point and has been very consistent in taking the steps she needs to take to get to where she is now."

The Course to a New Life

Driving by the former King Street, MRC Northampton VR office brought Paul Shattuck, Ph.D., back to a very different time in his life. His money was gone, his future uncertain and his back was in chronic pain. Fifteen years ago Paul's career as a licensed general contractor came to an abrupt halt when a back injury left him unable to walk for a month, and unable to work. As a carpenter with no employees, he had carried only minimal insurance and had no disability coverage. Suddenly, this hard-working man in his late twenties had no income and no sense of what he would do to replace it.

Paul doesn't dwell on the panic, the pain, or the tumult of losing his house and his business. His thoughts turn instead to the help and support he received from his VR Counselor Mike Tomasko. With the MRC's help, Paul was able to pursue a baccalaureate degree on a full-time basis, put his interest in helping children and families to use, and embark on a new life course.

Mike first met Paul when he was an unemployed carpenter whose injuries left him unable to work in his trade. For almost a decade, Paul had been taking occasional courses at night while working full time. Mike had assessments conducted and helped Paul evaluate his options. Mike took Paul's interests, drive and those college credits as a starting point, and together they created a vocational plan. Paul completed his rehab and physical therapy, resolved his financial crises, and sold his house, tools, and truck. While back pain plagued him for another four to five years, he devoted himself to his studies as a full time student. The MRC covered tuition, fees and some additional costs, while Paul paid for his daily living expenses. In 1991, he graduated from the University of Massachusetts with a baccalaureate in education, earning straight A's.

While in college getting a new start on life, Paul met his future wife. Together they moved to Oregon, where Paul took a job with the local community action agency. He quickly developed a reputation for his grant writing abilities, bringing in funds for a variety of programs targeting the poor and disadvantaged. His interest in the needs assessment part of grant writing led him to pursue a master's degree in sociology. Paul received two merit-based scholarships to attend Portland State University, and began to focus his interests in child development.

Paul then moved to Madison, Wisconsin, taking a position as a researcher with the Institute for Research on Poverty at the University of Wisconsin. He went on to pursue a doctorate in sociology from there as well, studying the impact and prevalence of autism among children and adults. He has published dozens of articles, and presented numerous papers to professional conferences and societies.

Paul continues to live in Madison with his family, where he is a postdoctoral fellow with the National Institutes of Health, pursuing research as part of the largest interdisciplinary effort on childhood learning disabilities in the world. He has been a consultant to the state and local departments of education on policy matters, and helped dozens of families get connected with resources and information. He plans to get more involved in policy formation in the years ahead and hopes his work will help children with autism get the education and support they need to thrive. He loves what he's doing, and can't imagine anything more fulfilling.

Paul gives a lot of credit to Mike's support. He recently sent him an e-mail with an update on his recent accomplishments. "You probably don't remember me," he writes, "but I probably wouldn't be here, a credentialed scientist with a great life, if not for the MRC's assistance and your guidance way back then on King Street. So I thought you'd appreciate knowing that things turned out so well for me in the long run."

Vocational Rehabilitation and Employment Services Facts and Figures FY '05

Vocational Rehabilitation Program

Outcome

Competitive Employment

Number of consumers in active participation

35,000

Number of new consumers with an IPE

5,776

Number of consumers successfully employed for 90 days or more

3,421

3,421

Integrated Independent Employment

Competitive Employment

Community Based Employment Programs

Goal

Total

Number of consumers served

600

538

Number of consumers who were placed in employment

175

181

181

Number of consumers who successfully maintained employment

160

167

167

Number of consumers in extended services

180

237

237

$ Expended

$1,810,001.15

Integrated Employment with Support

Competitive Employment

Supported Employment Program

Goal

Total

Number of consumers served

200

202

202

Number of consumers who completed program

45

46

46

$ Expended

$436,394.71

Facility Based Employment

Competitive Employment

Extended Employment Program

Goal

Total

Number of consumers who received services

821

808

Number of consumers who were placed in employment

5

3

3

$ Expended

$4,912,388.88


Total Consumers Successfully Placed into Competitive Employment


3,637

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 promote the independence of people with disabilities in Massachusetts. Official members are appointed by the Governor. The membership reflects a representation of persons with disabilities and disability advocacy groups, current and former consumers of vocational rehabilitation and independent living services, people in business and industry, the medical profession, education and community rehabilitation program providers. Members of the MRC State Rehabilitation Council are volunteers who donate their time to fulfill the mission of the MRC.

Appointees

Andrea Bader, Boston
Francis Barresi, Halifax
John Beach, Hyannis
Janet Dale, Milford
William Doherty, Arlington
Toby Fisher, Woburn
Brooke Heraty, Boston
Sandra Houghton, Quincy
Betty J. King, Boston
Barbara Lybarger, Boston
Warren Magee, Dorchester
Lisa Matrundola, Boston
William McCarriston, Avon
Mary M. Moore, Salem
Stephen Reynolds, Gloucester
Patricia Sheely, Pittsfield
Antonia J. Torres, Holyoke
Karin Williams, Boston

Ex-Officio Members

Owen Doonan, Duxbury
Suzanne Doswell, Pittsfield
Kevin Goodwin, Wayland
Anne P. Guterman, W. Newton
Inta Hall, Hingham
Keith Jones, Somerville
Jenna Knight, Worcester
Hang Lee, Milton
David Mortimer, Sudbury
Ann Marie Paulson, Lakeville
Ventura Pereira, N. Dartmouth
Carol Perlino, Lynn
Katherine Piccard, Charlestown
Serena Powell, Boston
Angelica Sawyer, Cambridge
Barry Sumner, Onset
Hartmut Teuber, Arlington Heights
Francis Verville, Fall River
Dwight Woodworth, Worcester
Pam Wool, Newbury

Community Services Overview

The Independent Living philosophy 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 purpose 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 institutional settings. This goal is part of the Governor's Community First Initiative and MRC's Community Services is proud of its accomplishments to move the Community First goal forward. The Community Services (CS) programs continue to grow to address the newly identified needs of its constituency. A major MRC initiative has been the expansion of access to Assistive Technology (AT) and CS saw the opening of the AT Loan Program in January as a result of its collaboration with Easter Seals of Massachusetts and Sovereign Bank. The MRC also received additional funding to continue its Home Modification Loan Program and expects further support for this program in FY '06.

Other significant CS accomplishments include the MRC becoming the Lead Agency for the Community Based Housing Program Initiative, acting as the designated state agency for the new Assistive Technology Act and bringing federal revenue into the Commonwealth through the Food Stamp Program by collaborating with MRC's Statewide Employment Services program and the Department of Transitional Assistance. The MRC Statewide Head Injury Program created yet another national model when it partnered with the Assumption College RCEP I to offer an Acquired Brain Injury Certificate Program for vocational rehabilitation counselors and community rehabilitation providers throughout New England. With the assistance of Consumer Involvement, the State Rehabilitation Council began planning and conducted its 25th Anniversary Annual MRC Consumer Conference held on December 1 and 2, 2005.

Community Services continues to expand its ability to serve those people with disabilities who do not have a "home" agency and while much still needs to be done, its efforts have been successful.

The Tools to Help Others

Massachusetts is home to hundreds of parks and recreation facilities that are astonishingly diverse, picturesque and accessible. Our park system is not simply accessible because of its low cost, proximity to major roads, and hospitality to families. The parks are also expressly accessible to people with disabilities. That accessibility reflects the commitment of the Commonwealth's Parks and Recreation Department, and in particular, to the work of Gigi Ranno.

Gigi directs the Universal Access Program, a division of the Massachusetts Department of Conservation and Recreation, which helps people with disabilities enjoy outdoor activities like fishing and kayaking. "We do this program so people with disabilities can enjoy their first camping experience with someone," said Gigi. "With just a small adaptation, we can do this as well as anybody."

Gigi has Multiple Sclerosis and uses a wheelchair when on the ground touring parks around the state. An active athlete and outdoors enthusiast before her diagnosis, Gigi sees no reason why people with disabilities can't enjoy the outdoors as much as others, and works to ensure this is possible throughout the system.

But Gigi might not still be directing this important program were it not for the help of Eugene Blumkin and the Massachusetts Rehabilitation Commission's Assistive Technology Program. Gigi's job requires her to travel to virtually every part of the state. Up until recently, she did so in a van that had limited supports for her. Now she drives a specially equipped four-wheel drive van that not only accommodates her disabilities, but can reach places throughout the year and across varying kinds of terrain. For this she thanks the MRC and Eugene, AT Program Principal Engineer, whose expertise, depth of experience, and insistence on quality ensured her van could meet her needs and address any contingencies she would probably not have imagined.

"For me, my biggest challenges came on days with high heat and humidity. My old van had a chair topper, and that was about it. I would basically have one chance to hoist myself into the driver's seat. If I failed, which would happen from time to time, I would collapse on the ground. I'd end up stuck there until someone would come along and help me get up. It was worse on the really hot days." Gigi coped with those conditions for quite some time, and might have continued doing so, had she not heard about the MRC program from someone who helped her up from the ground on a particularly hot day in Gardner. She had collapsed next to her van and the heat had left her unable to move.

When she learned about the MRC, she called Neil McNeil at MRC's Quincy VR office, who gave her some helpful guidance and referred her to VR Counselor Linda Palange, who explained the program to her. She received an evaluation at South County Hospital in Rhode Island, including a battery of tests and diagnostics on her needs, including her vision, driving, occupational skills, and a medical assessment. Most importantly, she learned about the range of technologies that can make vehicles function for drivers with disabilities.

Eugene reviewed her file and got to work on making sure Gigi would get a vehicle that fit her needs. What made Gigi's case unusual was that her job required traveling long distances and on non-paved roadways. He met with Gigi, and described the options South County Hospital recommended, and the process for getting her new vehicle. The MRC recommended some things Gigi did not expect, but has come to find extremely valuable. For example, based on Eugene's recommendation, the van has a tri-pin steering device, which allows Gigi to operate the van even if her hands and arms don't have the strength to use a full steering wheel. It also has a six-way power seat and a pair of side-opening automatic doors, enabling Gigi to get in and out of her wheelchair much more easily than she could have imagined.

Eugene ensured that the van had another helpful feature; a backbench seat that folds flat. For Gigi, fatigue can mean not being able to move at all. The backbench, together with the rest of the features in the van, enables her to rest in some degree of comfort so that she can travel on her job safely.

Eugene also ensured that the specifications were carried out exactly, quality checking each one, getting changes made, and making sure that it worked in practice as well as it did on paper. "Our services will provide you with a workable solution to a complex set of problems. We'll make sure you get everything you need, but to do that we have to go over everything at every step of the way. Things change. A new wheelchair, a piece of equipment you need at your job, anything, might alter the specifications."

Gigi cannot say enough about the program and especially the help and support of Eugene Blumkin. "Eugene was so helpful at every turn. He made sure the specifications were right, made sure I knew what was available and explained why he recommended the particular modifications, most of which I never would have thought of. One of the big ones is the remote starter. On hot days, if I get into a van that has sat in the sun all day, I'm in big trouble. With the remote starter, I can start the van from across the parking lot and have it starting to cool by the time I get to it. In fact, all the automatic features mean I am going to get into the van without overly taxing my body, or further limiting my ability to move."

Part of the Community

Right in the heart of downtown Pittsfield, the Ad Lib Center for Independent Living is, as their mission statement says, "empowering people with disabilities to live more independently and have control of their own lives." Ad Lib offers a range of services and programs from peer counseling to skills training, to transportation and personal assistance services. But, more than that, Ad Lib is a community.

Founded in 1983, Ad Lib serves the Berkshires and is supported by the Massachusetts Rehabilitation Commission, as well as the Department of Mental Health, the City of Pittsfield, the United Way and Medicaid. One side of the building looks like a typical business office, with numerous staff available to provide any of about a dozen services. On the other side of the building you will find an active community center with a television and pool table, computers and classroom space.

The core services provided at Ad Lib include peer counseling, meaning staff with disabilities help others with disabilities in the community to become more independent; information and referral services, which connects individuals with the resources they need to gain greater independence; advocacy on any number of issues related to independent living; and skills training.

Ad Lib additionally offers a Representative Payee Program which helps people manage their finances and meet their basic living needs. Ad Lib is also an educational resource for the community on issues concerning disabilities and the law through their ADA Technical Assistance Program.

Ad Lib also provides housing and transportation services and offers information and referrals.

Because of its unique position, Ad Lib can play an important role in identifying how the needs of individuals match up with the MRC's VRS Program services. People who may not have otherwise sought out training, job placement or other VR services are one step closer to changing their lives, simply because they came through the door to meet peers or talk about transportation issues.

Ad Lib's Drop-In Center Program offers structured and unstructured activities after business hours and on weekends. You can meet friends for dinner, play a game of pool or bingo, watch a Red Sox game, or take an art class. Anywhere from 30 to 50 people stop by the Drop-In Center on a given night.

The Drop-In Center is a community, but it is also an important part of the larger community. Since Ad Lib moved to its current location on North Street, Pittsfield in 1997, the Center has gained visibility. During local elections, candidates for mayor and city council seats come to Ad Lib to speak directly to their constituents. Ad Lib has also organized outdoor activities, like last year's Farnum's Challenge, an athletic competition where teams of people with and without disabilities competed in canoeing, cycling, running, and rolling.

Ad Lib continues to adapt and grow to meet the needs of its consumers. For example, when the Center began offering basic computer training on donated computers with the help of local teachers, staff learned that many of the Center's visitors couldn't read, so a literacy program was quickly developed to meet this immediate need. Because of the unique way consumers are actively involved in the operation and decision-making at the Center, it is always improving and finding new and better ways to contribute to the independence of Berkshire's disability community.

Always On Call

Protective Services Investigators are always on-call and never know what the day or even the next hour may bring. This small unit of the MRC, which currently has nine full-time staff members, is tasked with investigating allegations of abuse and neglect, and ensuring that consumers with disabilities in unsafe situations get the help they need.

Investigator Alyse Bukoski covers the region of the state from Worcester to the Berkshires and has been on the job for about two years. An investigator's job is multi-faceted and incredibly varied. Part investigator, part case manager, the job requires a great deal of creativity to ensure consumers are safe.

Reports of abuse or neglect come into the office and the investigation begins. This involves a certain amount of research in the office and a visit to the consumer's home. If a determination of abuse or neglect is made, Alyse must assess the risk and work with the consumer to find a way to make the situation safer, or get that person to a safe place.

Investigators work closely with law enforcement and are in touch with a network of organizations that provide resources to consumers. Every case is different and needs an appropriately tailored response. Protective Services Director Sabrina Cazeau-Class spoke of a recent case where a young woman with mental retardation was being abused by her parents. Police were contacted and her father was charged. Too young for battered women's programs and too old for teen crisis intervention programs, she needed the help of Protective Services and a quick, creative response. MRC staff were able to find the resources through interagency collaboration with the Department of Mental Retardation (DMR) to get her into a foster care situation where she could be safe and cared for appropriately.

The team faces a challenging workload, with 282 investigations last year. As Sabrina noted, "Lately cases have been more complicated and clinically challenging. We are seeing a greater intensity of investigation where the situation is not clear cut and we are dealing with multiple issues; alcoholism, abuse, child care issues."

Protective Services has also seen an increase in the of cases involving people between the ages of 18 and 25, and have found invaluable the services of MRC's Turning 22 Program for helping many of these consumers. MRC staff often work collaboratively across programs and departments to offer a range of expertise and options that no single program by itself could. The Turning 22 Independent Living Program provides transition services for young people with disabilities who need residential services after high school. The program's independent living philosophy encourages consumers to make their own decisions about their lives, offering the resources necessary to make an informed choice. Knowing what resources are out there for individuals with disabilities is critical to helping consumers to successfully find their way to a safe and stable living situation.

A key component of the job is to educate consumers while respecting their right to choose. Someone may get out of an abusive situation only to find themselves in another unsafe environment later. It is important that they know where to turn for help. Investigators are also more than willing to offer their expertise to other agencies and departments to educate staff about identifying and reporting cases of abuse or neglect.

The range of issues that face the investigators in Protective Services clearly make this a challenging job. Alyse speaks of being called away from one investigation to respond to a more urgent crisis. But Alyse speaks not in terms of what she gives but of what she gets out of her work, "We meet some incredible people in our work. Is it frustrating? Yes. Challenging? Yes. Rewarding? Without a doubt."

A Valuable Addition to the Team

Eric Shamus first heard about the Massachusetts Rehabilitation Commission while volunteering at the Asperger's Association of New England, when he was looking for a job. Eric has Asperger's syndrome himself and had found it to be an obstacle in his job search. The neurological disorder can impede successful social interactions. Eric's face provides few clues on his thoughts or feelings, and his verbal expression is generally deliberate and measured, regardless of the topic. Without smiles, eye contact, and the typical pace and tone of conversation, it can be hard to establish trust and rapport, putting the person with Asperger's at a substantial disadvantage.

Eric first connected with the MRC's Statewide Employment Services (SES) through Christina Sseskandi. At the time Christina worked for MRC vendor Networks/Enable, Inc., but she has since become an MRC SES Program Specialist.

Christina did a profile of Eric and together they crafted an individual service plan and submitted it to Cindy Gallant, Program Specialist for SES, who was able to quickly approve it. SES administers programs to people with severe disabilities who typically need long-term support to enable them to retain meaningful community-based employment.

Christina, along with Cindy's collaboration, worked with Eric on resume writing and interview techniques. Together they focused on helping Eric make his interpersonal contacts more successful, practicing initial greeting techniques, steady eye contact, and responses to typical social interactions.

Eric worked hard to incorporate what he learned and soon located job opportunities in animal care. Eric had a bachelor's degree in liberal arts from Becker College with a minor in animal care, one of the few such degrees in the country.

Despite his strong qualifications, interviews were not leading to offers, and Eric wondered if his Asperger's was the reason. Christina was able to reassure Eric that employers routinely delay making decisions, and that job offers come far less frequently than job interviews. She continued to work supportively with Eric, emphasizing his need to smile and engage, encouraging him to start fresh with each new opportunity. They discussed expanding his job search into less appealing areas, such as clerical work, but decided to stick with the plan a little bit longer. Eric was appreciative of Christina's patience.

"They were able to screen out certain businesses we went to that wouldn't be a good placement. Whenever we would finish going on an interview for a potential job we would always be in agreement as to whether it was a good match. I thought it was very helpful," Eric said of his experience with Christina.

The process took about a year, with Eric and Christina in contact nearly every week. The payoff for their efforts finally came when they went to an interview together at the Skipton Kennel in Waltham. Owner Karen Carlis saw in Eric just the sort of employee she was seeking. Although aware of his disability, it didn't strike her as an obstacle and she hired him immediately.

"Eric is a dog whisperer," says Karen. "We are all part of a team, but we're just so lucky to have his skills in controlling and relating to these dogs. Each one is different, but somehow Eric seems to be able to communicate with them all." Karen knows that Eric works very hard to succeed at Skipton Kennel and gives him a lot of credit for his efforts. He is now an essential member of their team, which Karen describes more as a family.

The Road to Independence

In February of 1991, Jim Viggiano moved out of a nursing home and into his own apartment. Jim had spent the first 40 years of his life institutionalized and in state hospitals in order to receive the care and services everyone thought was required to manage his disability. Jim has Cerebral Palsy (CP) but was determined to live independently. His advocacy for himself and others continues to surprise those who would underestimate him.

Cindy Wentz, Independent Living Program Coordinator for the MRC, began working with Jim in 1992. "Jim is a great example of what the Supported Living Program does for people who are determined to live independently. Jim is a man of great intelligence who is active as an advocate for both himself and the disability community." Jim was one of the first consumers served by the Adult Supported Living Program, which helps people with significant disabilities find a community living situation to meet their needs. Currently the MRC is serving close to 100 individuals with developmental disabilities who have transitioned into community living. Cindy ensures that Jim receives the services and support he needs through Work, Inc., the agency providing daily assistance to help Jim live independently.

Although Jim is non-verbal, he has strong writing skills and has taken advantage of assistive technology by using a talking computer and WebTV for e-mail. Tom Nesbit, Jim's case coordinator from Work, Inc., tells a story of how Jim used the various voices available through the talking computer, including female voices, to play a joke on Tom. The computer, the Vois 160, has been an invaluable tool for Jim, enabling him to take care of business on the phone, as well as keep in touch with friends and family. Cindy also keeps in touch with Jim through e-mail, as he is an avid e-mail user. In a recent e-mail to Cindy, Jim spoke about how he had far exceeded the expectations set for him as a child. "When I was two years old, the doctor told my parents to put me away and forget about me, that I wouldn't be anything but a vegetable. How many e-mails have you received lately that were typed by a vegetable, Cindy?"

Jim's determination and success in being part of the community are reflected in his involvement in political campaigns and his advocacy with local officials regarding safety issues critical to the disability community. Jim is especially interested in neighborhood safety. His latest campaign is an attempt to slow the traffic on his street, which is a real threat to his safety, as cars often speed by even when Jim is clearly in the crosswalk. He is educating people about "traffic calming," which is a way to both beautify the streets and slow traffic through physical modification of the roads.

Jim somehow finds the time to manage his life at home, get involved in political and advocacy campaigns, and occasionally work as a DJ for dances and parties. Jim and Tom work closely with all the relevant federal, state and local agencies to obtain the funding, support and services Jim requires, including the management of a team of Personal Care Attendants. The support and advocacy of Cindy at MRC and Tom at Work, Inc., have given Jim a level of control and independence that allows for a much enriched lifestyle.

Another individual with CP who was assisted in moving out of a nursing home is Kathleen Eid. Kathleen's services are provided by the MRC Nursing Facility Transition Project. Kathleen has demonstrated emphatically that it is never too late to change your life if one has a vision and is able to obtain the support needed to make that vision become a reality.

When Kathleen's parents died, she was moved into a nursing home at the age of 39. Kathleen was part of a class action settlement on behalf of individuals with developmental disabilities; the MRC was charged with placing some of these people back into the community. With the help of Mary Adams, the first Nursing Facility Transition Coordinator hired by MRC, she has been able to find the right living situation. One of Mary's first action steps was hiring a vendor, Networks/Enable, Inc., to provide the support and ongoing services Kathleen requires. As Mary indicated, "Kathleen had the courage to step into the unknown. She was able to trust a state agency with her life, in spite of her fears. But she has a zest for life and wanted to return to her community and live independently, after having lived in a nursing home for over 20 years."

Kathleen and Mary worked together for almost a year before finding the right living situation. It became apparent that the apartment model was not adequate for Kathleen, despite her desire to live in a community setting. As Mary stated, "We went on a quest for the right setting…. but it also took a lot of trust by Kathleen to move away from the apartment model." The quest ended when Gabriel House in Fall River was identified as the right place for Kathleen. The move required Mary to enter into important negotiations with the facility's management to ensure that Kathleen's needs would be met. Gabriel House, an assisted living program, is not accustomed to having residents with the range of services required by Kathleen. Mary and her supervisors at the MRC arranged with MassHealth to have an overnight Personal Care Attendant (PCA) stay with Kathleen and added extra staff to help Kathleen dress and have her breakfast before leaving for her day program.

Kathleen's independence is reinforced by the fact she pays 30% of her income toward Gabriel House costs, with the MRC paying for the rest, plus her support services. Jocelyn Turner, Case Manager from Networks/Enable, makes sure Kathleen receives all the services she needs, oversees the PCAs and also helps Kathleen pay her bills and manage her finances. In addition, the cost for Kathleen to live at Gabriel House is also thousands of dollars less than a nursing home.

When Kathleen began living at Gabriel House in July 2003 she participated in a day program for people with developmental disabilities. Eventually, Kathleen decided she wanted to "retire" from the program to become more engaged in the activities and life at Gabriel House. Mary and Jocelyn attended a large party held for Kathleen, with friends and family present to celebrate and "roast" Kathleen. Mary noted, "It was the first party ever held for Kathleen and a very significant event in her life. She was really moved and touched by the party."

After retirement, Jocelyn and Mary arranged for a life skills coach to assist Kathleen in transitioning from her day program to daily life at Gabriel House. The life skills coach has helped Kathleen with her communication skills, which has resulted in more involvement with the residents. Kathleen now enjoys participating in exercise classes, arts and crafts, and monthly meal outings. Kathleen also takes part in the religious services offered in the residence and on occasion leaves to attend church on Sundays. Being very religious, the ability to attend these services is especially important to Kathleen. The location of Gabriel House in Kathleen's home town allows her to spend holidays and special occasions with the family members who still live in the area.

Retirement from day services was a novel concept for both Kathleen and MRC. Mary credits her supervisor, Beth Williams, and director, Debra Kamen, with giving her the flexibility and support in developing creative approaches for addressing Kathleen's needs. Mary observed that, "This can be a very stressful job but very rewarding when you place someone in the right environment. We are all proud of Kathleen." She concluded that Kathleen's experience has been so successful in part because of her motivation, a very good match with the vendor, and the MRC's ability to be creative as she ages.

Community Services Facts and Figures FY '05

IL Center Services

Total

Number of consumers who received services

14,625

Number of information and referral calls

12,258

$ Expended

$4,493,253


Turning 22 Services

Number of consumers who received services

75

Number of new Individual Transition Plans

9

Number of new referrals

9

$ Expended

$3,063,643


Assistive Technology

# of consumers who received services

114

Number of consumers on the waiting list

47

$ Expended

$573,100


Housing Registry

Number of new listings

125

Number of vacancies

291

Number of housing calls to IL Centers

15,255

$ Expended

$84,500


Supported Living Services

# of consumers who received services

96

Number of consumers on waiting list

38

$ Expended

$837,739


Head Injury Services

Number of consumers who received services

1173

Number of services purchased for consumers

1129

$ Expended

$12.9M


Home Care Services

# of consumers who received services

1811

Number of new cases opened

405

Number of hours of services provided

220,000

$ Expended

$4,995,998


Protective Services

Number of consumers who received services

282

Number of new service plans

126

Number of consumers provided paid services

98

Number of investigations

282

$ Expended

$575,230

Disability Determination Services Program 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 Insurance (SSDI) and/or Supplemental Security Income (SSI) benefits. Last year, the Massachusetts DDS processed less than 80,000 cases which represents a decrease from the previous year. This decrease was the result of the Social Security Administration designating Massachusetts as a pilot state in the implementation of the "folder-less" process beginning in 2005 and scheduled for completion in April, 2006.

The Social Security Administration measures the performance of each DDS annually and the MRC-DDS continues its leadership role as one of the most productive in the nation. This results in quicker decisions for residents of Massachusetts with disabilities making application. The MRC DDS decisions are made, 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 staffs with special training who provide services to the homeless population as well as those with HIV. Our homeless initiative continues to partner with other state and federal entities to provide a more coordinated and goal directed service. Additionally, the MRC-DDS continues to provide much needed service to the entire New England Region by completing cases from other states, providing staff to a federal investigation unit and providing expert staff to the SSA Regional Office.

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 toward increased independence. It allows for 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 competitive work.

A Job Well Done

A successful medical review examiner for the MRC Disability Determination Services Program must possess an extraordinary complement of skills and abilities. She must have outstanding organizational skills and be compassionate and understanding. She must know the rules and regulations governing eligibility and must also have extensive knowledge of medical conditions, terminology, human physiology and psychology, and a gift for hearing things that are not said. She must juggle a large caseload with an unrelenting supply of new applicants while maintaining a good sense of humor and optimism.

Fortunately, the MRC-DDS has Kristine Robbins. In April, 2005, Kristine received the Social Security Commissioner's Award for Performance.

Kristine attributes much of her success to the support and leadership from the MRC, her colleagues and her supervisor, Barbara Kinney.

Kristine's mantra is: "Everyone with a disabling condition has their own story." Kristine views her job as the place where that story will be heard.

At the end of the process, including determinations on residual functional capacities, medical consultations, reviews on activities of daily living, and the associated documentation, Kristine wants to know that every case was heard fully and fairly.

"You just don't know what's really happening on the other side of that phone; when that call comes in, you might be their lifeline and not even know it," Kristine explains. She says that often a person will call describing one condition that does not qualify for benefits, then, unknowingly, reveal later that he or she does have a qualifying condition. The variety and interconnectedness of mental health, physical health, injuries, acute and chronic conditions are not always apparent with the first call, referral, or interview. Kristine gets the real story by keeping communication channels open, attending to details, and maintaining her sense of empathy and compassion.

This approach might be more labor intensive, yet Kristine has exceeded expectations in the number of RFCs completed on a monthly basis. New cases arrive daily, but her enthusiasm and commitment never seem to wane.

Kristine begins her day at 7:00 a.m., when she reviews the cases that came in the day before. She considers each case with respect to its difficulty, likelihood of success, and need for documentation. She gathers and organizes the information needed for the disability determination and speaks with applicants and doctors. She reviews key dates, such as the date of injury and date last insured. Kristine also watches for any indication of fraud or abuse and her more than ten years of experience in the field help her see through false claims and exaggerated conditions.

Kristine genuinely enjoys her work. She speaks warmly about her colleagues and is grateful to have such a supportive and helpful supervisor. What really conveys Kristine's love for her job is the way she speaks of consumers. She cherishes the occasional note from someone whose life has stabilized through SSDI benefits. Most of all, Kristine knows that the person calling has a story to tell. "Sometimes, people don't even know themselves what their conditions are, they've been living with them so long," she explains. "You just have to remember they're human beings and make sure you get everything you need to resolve their case correctly."

DDS Facts and Figures FY '05

(October 1, 2004 - September 16, 2005)

Total Receipt of Cases: 78,440

Total Dispositions of Cases: 78,678

Initial Claims Filed: 51,023

Percent Allowed: 45.7%

CDR Receipts: 11,921

CDR Dispositions: 20,392

Consultative Examinations Purchased: 20,323

Consultative Examination Rate: 25.8%

Medical Evidence of Record Purchased: 61,150

Medical Evidence of Record Rate: 77.7%

Total Medical Costs: $6,464,000

Total Budget: $34,270,000

Cost Per Case: $435

Accuracy of Decisions: 96%

Total MA Population: 6.3M

DDS Advisory Council Members

The Disability Determination Services Advisory Committee was formally established in the early 1980s. 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
Inta Hall, Hingham
Chris Czernik, Lynn
Linda Landry, Esq., Boston
Shirley Dopson, Jamaica Plain
Jenny Pickett, Lawrence
Gail Havelick, Boston
Barbara Seigel, Boston
Joanne Shulman, Framingham (Chairperson)

State Funded Services FY 2005

Division

Vocational Rehabilitation

$15,201,423

32%

Community Services All Other

$21,092,236

44%

DMR Allocation- Rolland Case

$4,592,943

10%

Head Injury Trust Fund

$6,644,794

14%

Total

$47,531,396

MRC Federal Funded Services FY 2005

Appropriation Name

Vocational Rehabilitation / Federal (48%)

$37,869,744

Vocational Rehabilitation / SSA (3%)

$2,768,502

Supported Employment (1%)

$659,062

Disability Determination Services (43%)

$34,121,602

Community Services (2%)

$1,564,945

Other Federal Spending (3%)

$2,361,761

Total Federal Funds Expended

$79,345,616

Five Year Federal Funds Spending

Appropriation Name

FY2001

FY2002

FY2003

FY2004

FY2005

Vocational Rehabilitation / Federal

36,080,761

37,556,997

32,661,008

34,968,971

37,869,744

Vocational Rehabilitation / SSA

4,972,091

986,322

1,019,501

1,892,134

2,768,502

Supported Employment

629,062

876,112

662,795

742,064

659,062

Disability Determination Services

29,482,072

30,834,655

31,669,363

33,268,170

34,121,602

Community Services

1,211,396

1,309,805

1,405,846

1,560,730

1,564,945

Other Federal Spending

438,385

796,915

993,553

933,434

2,361,761

Total Federal Funds Expended

72,813,767

72,360,806

68,412,066

73,365,503

79,345,616

In June of 2006 the Massachusetts Rehabilitation Commission will be celebrating fifty years of service to the disability community 1956 to 2006.

Mitt Romney, Governor

Kerry Healey, Lieutenant Governor

Timothy Murphy, 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), 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.