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Originally Processed With FOIA(s): FOIA Number: S S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: Donated Historical Materials Collection/Office of Origin: Frieden, Lex, Collection Series: Printed Materials Subseries: Reference Materials OA/ID Number: 52138 Folder ID Number: 52138-004 Folder Title: Client Assistance Projects [1975-1978] Stack: Row: Section: Shelf: Position: Ombudsman Vocational The project staff must be as- sured direct communication with top Rehabilitation Process state agency administrators; but, they must also respect the client/coun- selor relationships and resolve practi- cal problems at a local level. LESLIE B. COLE All clients or client-applicants in the project area must have free access to the project for advice and counsel; but, the project staff must "Ridiculous!" "Right on!" "What ble methodology. What is most im- advocate for other services through do you mean by that?" "How can portant is that over 2,000 handi- the existing VR personnel. they help?" "It's about time!" "Well, capped persons have already In the first instance, there have let's think about it." Do you associ- benefited in tangible ways. been numerous professional "anxie- ate any of these reactions with the These are pilot projects, first au- ties" expressed about the potential position you are now taking when in- thorized by the U.S. Congress under interference and monitoring by new novations for the State-Federal pro- the Rehabilitation Act of 1973. Dur- project personnel who would have gram for vocational rehabilitation are ing debate on the bill in Congress, very little VR program background. under discussion? The program is client assistance projects were con- However, the first annual reports just being scrutinized, you know. Mostly, sidered a controversial program be- received from the original 11 proj- perhaps, because it has always held cause of their association with the ects indicate that because considera- great promise for responding to sig- word "advocacy." ble time during the first months was nificant social and personal needs. It Some felt that the traditional voca- used in staff education (in both is a time-tested system and there is tional rehabilitation program, over directions), significant respect, confi- an accountability tract which invites 50 years in existence, had deep com- dence, and, in some cases, reliance analysis and, therefore, invites criti- mitments to the personal welfare of developed between ombudsmen and cism. It's also a program which can handicapped people and, therefore, agency professional staff. The follow- survive criticism by offering a re- needed no other official client advo- ing quote from one project seems to sponse and alternatives. That is what cates "interfering" with the coun- be representative: "When client as- this article is all about. selor/client relationship. sistance was beginning to organize, An interesting and remarkably Others, heeding the public testi- and they were doing their initial pub- productive group of projects started mony of dissatisfied and frustrated lic relations with counselors and su- in June 1974. They are known as handicapped persons and groups, pervisors, I was worried that they Client Assistance Projects. As this argued for an experimental program would be extremely biased in favor name indicates, they are consumer identified with ombudsmen who of the client. From their statistics oriented, but, they are administered would use advocacy rather than ad- and my own personal experience, by state vocational rehabilitation versary methods in overcoming prob- this was a needless worry. In all agencies. That fact alone could raise lems. Astute foresight was reflected cases, client assistance can help a question for some people because a in several stipulations written into with client/counselor communica- main purpose mentioned in the law the final law with respect to project tions, thus leading to better services creating these projects is to person- organization and operation. for the handicapped." ally help clients who are having diffi- Let's look at these major con- In the second instance, the lines of culties in understanding the service straints and briefly consider the authority appear to be direct and system, and, those who are having problems which might be evoked: workable although exercised differ- problems regarding the services Each project must be directly ently from project to project. For ex- which flow through that system. It funded and administered by the state ample, one ombudsman adopted a has been quite a challenge to quickly vocational rehabilitation agency; but, policy of communicating only with establish 11 such projects that are no project staff can be currently em- counselors when clients raised a geographically dispersed around the ployed or be receiving benefits under problem, even though there were country and with each having a flexi- the VR agency. natural linkages with supervisors re- Reprinted from: AMERICAN REHABILITATION U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Rehabilitation Services Administration Information, Our Most Precious Commodity And AR is the place to get it. If you already subscribe, pass this along to a colleague. Subscription NAME-FIRST, LAST form for ORGANIZATION American Rehabilitation ADDRESS CITY STATE ZIP CODE REG. Send check, payable to SUPERINTENDENT OF DOCUMENTS to the U.S. Government Printing Office, Washington, D.C. 20402 Yearly subscription: $11.75; Foreign: $14.70; per copy: $2. Calvin Melton STATE OF FLORIDA DEPARTMENT OF Reubin O'D Askew, Governor Health & Rehabilitative Services 1317 WINEWOOD BOULEVARD TALLAHASSEE, FLORIDA 32301 DATE: February 20, 1978 TO: Participants of the Fourth Annual Meeting of Client Assistance Project Directors FROM: J. H. Hutchison, Ph.D., Director, Office of Vocational Rehabilitation RE: Client Assistance and Advocacy Program This information packet has been put together to inform you of the activities under- taken, and the relationships developed between the Florida Client Assistance and Advocacy Program and the Office of Vocational Rehabilitation. The C.A.A.P. is the result of a statewide expansion of the Client Assistance Project established in Orlando in 1974. The Coordinator is now in the Program Office and in addition to carrying out the purpose and goals of the original project, he is working to develop and strengthen relationships between OVR and handicapped consumer organizations. A Toll-Free number (1-800-342-0778) has been established in order for clients/consumers to contact the C.A.A.P. Contracts have been developed between OVR and consumer organizations which call for disabled advocates to assist in carrying out the goals of the Client Assistance and Advocacy Program. An addendum to the counselor manual has been drafted explaining the C.A.A.P. to counselors and outlining their responsibilities and relationship to the Program. In addition, the Agreement of Understanding has been revised to include the Toll-Free number, two copies will be made, one for the client's file and one to be given directly to the client. We are most enthusiastic about the potential of the C.A.A.P. for establishing itself as an advocate for our clients, OVR, and the philosophy of rehabilitation itself. If you have any questions regarding our program, please do not hesitate to contact us. J. H. Hutchison, Ph.D., , Director Office of Vocational Rehabilitation Frank E. Woodrich, Coordinator Client Assistance E Advocacy Program Office of Vocational Rehabilitation JHH/W/br In establishing a philosophical and working relationship between the Client Assis- tance and Advocacy Program (C.A.A.P.) and the Office of Vocational Rehabilitation, it is imperative that one understands the legal basis in which the original Client Assistance Projects (CAPs) are grounded, as well as their purpose. LEGAL BASIS The legal base for our C.A.A.P. is Public Law 93-112, Rehabilitation Act of 1973, as amended by Title I of Public Law 93-516, Section 112; and 45 CFR 402.45. PURPOSE The purpose of establishing the Client Assistance and Advocacy Program is to provide information and counsel to Vocational Rehabilitation clients and client applicants of available benefits under the Act, and upon request of such clients or client ap- plicants, to assist them in their relationships with the personnel, programs, and facilities providing services to them under the Act. In Section 112 of the Act, Congress indicates its desire to overcome certain defici- encies which, according to public testimony, sometimes manifest themselves in the Vocational Rehabilitation Program, such as: A lack of clear communication between the counselor and client; poor communication between the administrator of a faci- lity and the client; and the inability of some clients to understand the require- ments and procedures of the Program. The emphasis is on service to the severely disabled. PHILOSOPHY Congress further emphasized that programs such as C.A.A.P. should be established on the basis of mutual cooperation with Vocational Rehabilitation staff. Problems are to be resolved as quickly and as amicably as possible without assuming an adversary role. The importance of the close working relationship between the client and the -1- Vocational Rehabilitation counselor is not to be diminished by the C.A.A.P. Pro- gram personnel should not stand in the way of that relationship by supplanting or reducing it in any way. BASIC CONCEPTS AND SCOPE The Client Assistance and Advocacy Program should generally be oriented to overcom- ing individual problems in specific cases and addressing general problems which may have been created by the system. The Program should be directed primarily to the needs as perceived by the client regarding the service delivery system and his reac- tions to that system. The essence of the provision of Assistance and Advocacy ser- vices is to answer questions and help clients overcome problems related to services available under the Rehabilitation Act. They should also have a characteristic of anticipating client problems with the system, and preventing "drop-outs" by introdu- cing ombudsman services as appropriate. Practical, expeditious, and empathetic res- ponses must be provided to client requests for assistance. The C.A.A.P. should not be merely a modified information system or a general clearing- house for referral. Interpreting the Vocational Rehabilitation Program to the client should continue to be a responsibility of the Vocational Rehabilitation counselor. However, if a client and a counselor are not relating well together, either the client or the counselor might properly take the initiative to seek help from the C.A.A.P. RELATIONSHIPS TO OTHER VOCATIONAL REHABILITATION PERSONNEL It is important that C.A.A.P. workers understand the Vocational Rehabilitation philo- sophy, procedures, and constraints, and for Vocational Rehabilitation personnel to understand and be oriented to the goals of the C.A.A.P. The Client Assistance and Advocacy workers' role is to address rehabilitation problems related to situations as clients perceive them. Desirable solutions might come from fresh approaches. A positive approach and openmindedness may be the essential pattern for all involved. The Vocational Rehabilitation counselor remains the key figure regarding Vocational -2- Rehabilitation services, yet the C.A.A.P. worker may realistically want the counselor to reconsider some action which has been taken or denied and try to cope with problems as perceived by the client. PROGRAM OFFICE SUPERVISION AND MONITORING Rehabilitation Services Administration (RSA) holds the State Vocational Rehabilitation agency as responsible for organizational and operational policies of these programs. Therefore, the Coordinator of C.A.A.P. is accountable to the Vocational Rehabilitation Administrator. The Coordinator submits an annual report on operations and outcomes which is transmitted through the State Agency Administrator to the Secretary of HEW. It is imperative that the Coordinator of C.A.A.P. have access to the Vocational Re- habilitation Program Administrator at all times. Needless to say, this should be a mutual convenience. Resolution of possible programmatic conflicts between the C.A.A.P. and the Vocational Rehabilitation staff and/or Program should be resolved by appropri- ate consultation between the Coordinator and the Vocational Rehabilitation Administrator ADVOCACY APPROACH OF C.A.A.P. Advocacy activity that interacts with the service delivery system and attempts to ren- der human service agencies more responsive to the clients they serve, has resulted in two conflicting viewpoints. One viewpoint contends that the only kind of advocacy that can possibly succeed is "external advocacy," or advocacy that operates from outside the system and is exter- nally supported. A second viewpoint says that "internal advocacy," or advocacy that is supported internally and works from inside the system, is a better approach. The Client Assistance and Advocacy Program adopts the latter philosophy. The C.A.A.P. is an internal advocate primarily because it is supported by the system in which it works. -3- While the C.A.A.P. contends that the Vocational Rehabilitation client needs advocacy activities and that the system may need some reform or renewal, we feel this can be best accomplished by activity from inside the system. The C.A.A.P. as an internal advocate is committed to identifying individuals whose rights and needs are not be- ing met by the system in which we are employed. Our goals focus on activity that may change the system to be responsive to the client and his needs. The C.A.A.P. is committed to negotiation with counselors, supervisors, and service providers. External advocates often view themselves as adversaries of the system and are prone to see negotiations as a waste of time. They frequently move quickly to confrontation. While there appears to be an advantage in confronting the system from the outside, I believe this advantage is negated by the advantages of advocating from an internal position such as C.A.A.P. The great advantage of internal advocacy programs is the access to the environments or programs in which the clients are served. External advocates must often rely upon information that is reported to them from other sources. To the extent that an advo- cate is unable to collect information personally, information upon which they base their actions may be vague, misleading, or even faulty. Nothing is as sure to erode the credibility of an advocate more quickly than false data. A cardinal rule for an advocate is to act only upon reliable information. There are many good people in the system who are keenly sensitive to client needs. These people in the system are natural advocates. Unlike external advocates, internal advocates are able to discover and relate to these natural advocates. With reference to requests by clients for administrative reviews and fair hearings, the Client Assis- tance and Advocacy Program will provide the kind of information, advice, and assistance that will serve to reduce such requests. However, in the event of an administrative review, or a fair hearing, the Coordinator of the C.A.A.P. may attend either through -4- an invitation extended by the Director of the Office of Vocational Rehabilitation, or through the request of a client. In summary, if the cooperative philosophy and ready access between the Coordinator and the Vocational Rehabilitation Program Administrator is part of this working relationship, then the C.A.A.P. will establish itself as an advocate for the client, the counselor, the Office of Vocational Rehabilitation, and the philosophy of rehabilitation. -5- AGREEMENT OF UNDERSTANDING On the basis of information collected by my counselor and me, I may be found eligible for rehabilitation services and a program planned for me with my help. I understand that this program can change as circumstances change and my program can be ended if it is found not likely that I am able to work. I also understand that my counselor and I will re-evaluate my program from time to time to determine my progress toward becoming employed. My program will be reviewed at least once a year at which time my counselor and I have the opportunity to make any changes necessary. If problems arise that I cannot work out with my counselor or his/her supervisor, I may call the Client Assistance and Advocacy Program TOLL-FREE at 1-800-342-0778 regarding my program. They will provide assistance and advice as well as explain my rights to review by the District Vocational Rehabilitation Program Supervisor. Additionally, I have opportunity for a fair hearing before the Director of the Office of Vocational Rehabilitation or his representative. If I am not found eligible for services, I understand my counselor will discuss the reasons with me. I will have the opportunity to re-apply for services should there be a change in my situation. Similar benefits from other agencies both private and governmental have been discussed with me, and when pertinent, they will be used in my rehabilitation program. I understand that all information given by me or about me will be held conficential by Vocational Rehabilitation. Release of this information to any person, agency, or organi- zation will be done only with the assurance that the information will be used only to further rehabilitation efforts in my behalf. I understand that all services provided are without regard to race, creed, sex, or national origin. The provisions of affirmative rights legislation has been explained to me. Signature Date HRS FORM 56, JAN. 1978 ADDENDUM #2 CLIENT ASSISTANCE AND ADVOCACY PROGRAM In establishing a philosophical and working relationship between the Client Assistance and Advocacy Program (C.A.A.P.) and the Vocational Rehabilitation Program, it is imperative that one understands the legal basis in which the original Client Assistance Projects (CAP's) are grounded, as well as their purpose. LEGAL BASIS The legal base for the C.A.A.P. is P.L. 93-112, Rehabilitation Act of 1973, as amended by Title I of P. L. 93-516, Section 122; and 45 CFRS 1362.45. PURPOSE The purpose of establishing the Client Assistance and Advocacy Program is to provide information and advisement to all Vocational Rehabilitation clients and client applicants of all available benefits under the Rehabilitation Act of 1973, and upon request of such clients or client applicants, to assist them in their relationships with the personnel, programs, and facilities providing services to them under this act. In Section 112 of the Act, Congress indicates its desire to overcome certain deficiencies which, according to public testimony, sometimes manifest themselves in the Vocational Rehabilitation program, such as: a lack of clear communication between the counselor and client; poor communication between the administrator of a facility and the client; and the inability of some clients to understand the requirements and procedures of the program. The emphasis is on service to severely disabled people: PHILOSOPHY Congress further emphasized that programs such as C.A.A.P. should be established on the basis of mutual cooperation among regular Vocational Rehabilitation staff. Problems will be resolved as quickly and as amicably as possible without assuming an adversary role. The importance of the close working relationship between the client and the Vocational Rehabilitation counselor is not to be diminished by the C.A.A.P. Program personnel will not stand in the way of that relationship by supplanting or reducing it in any way. The Client Assistance and Advocacy Program should be viewed as a resource for clients, counselors, and the community. 15-5 BASIC CONCEPTS AND SCOPE The Client Assistance and Advocacy Program is generally oriented to overcoming indivídual problems in specific cases and addressing general problems which may have been created by the system. The program is directed primarily to the needs as perceived by the client regarding the. service delivery system and his reactions to that system. The essence of the provision of Assistance and Advocacy services is to answer questions and help clients overcome problems related to services available under the Rehabilitation Act. They should also have a characteristic of anticipating client problems with the system, and preventing "drop-outs" by introducing ombudsman services as appropriate. Practical, expeditious, and empathetic responses must be provided to client requests for assistance. The C.A.A.P. is not merely a modified information system or a general clearinghouse for referral. Interpreting the Vocational Rehabilitation program to the client continues to be a responsibility of the Vocational Rehabilitation counselor. However, if a client and a counselor are not relating well together, have sought help from the supervisor, and are still having problems, the client or the counselor might properly take the initiative to seek help from the C.A.A.P. A Toll-Free number, 1-800-312-0778, has been established in the Coordinator's office for that purpose. RELATIONSHIPS TO OTHER VOCATIONAL REHABILITATION PERSONNEL It is important that C.A.A.P. workers understand the Vocational Rehabilitation philosophy, procedures, and constraints. Also, it is important for Vocational Rehabilitation personnel to understand and be oriented to the goals of the C.A.A.P. Client Assistance and Advocacy workers should not be unduly restrained by traditions since their role is to address rehabilitation problems related to the situations as clients perceive them. Desirable solutions might come from fresh approaches. A positive approach and openmindedness will be an essential pattern for all involved. The Vocational Rehabilitation Counselor will remain as the key figure regarding Vocational Rehabilitation services, yet the C.A.A.P. workermay realistically want the counselor to reconsider some action which has been taken or denied and try to cope with problems as perceived by the client. 15-6 ADVOCACY ACTIVITIES Advocacy activities are an important function of the Client Assistance and Advocacy Program (C.A.A.P.). It will utilize disabled members of handicapped consumer organizations to conduct community education and modification. Advocating for someone means actively supporting, or pleading their cause. Its derivation is from the Latin ad, meaning. to, and vocare, meaning to call or to vocalize for. Advocacy activities in rehabilitation mean insuring disabledpersons their rights to appropriate services. Our clients need advocacy because they generally do not possess the qualities to function as advocates for themselves. Lack of money, education, training, confidence, and influence make it imperative that someone act in the client's behalf. The rehabilitation counselor must remain as that person. !lowever, the expertise and knowledge needed to deal with recent federal legislation, combined with the emphasis on serving the severely disabled, places additional responsibilities on the agency, counselor, employers, and the community, which advocacy programs may effectively relieve. Recent legislation has produced terms such as non-discrimination on the basis of handicap, affirmative action, barrier-free environment, reasonable accommodation, and Individualized Written Rehabilitation Plans. These terms and their implications have produced new challenges for the rehabilitation professional and for the community as a whole. Before rehabilitation can properly serve people with severe disabilities, it must be allowed to address the attitudinal and environmental barriers that confront disabled people. Lack of accessible transportation, barrier-free housing, and attendant care are just a few of the problems that prevent the mainstreaming of people with disabilities into community life. By virtue of their good health, non-disabled people are capable of physical independence and self-determination. This capability makes it difficult for them to consider the loss of their physical freedom, and virtually impossible for them to consider realistic ways of circumventing physical disability and developing alternative methods of achieving independent living. Because of this mentality, the community must be modified and educated to the personal, social, recreational, educational, 15-7 and vocational needs of disabled people Through workshops, seminars and in-service training, disabled advocates can educate clients, counselors, employers and the community as a whole to each of their responsibilities under Title V of the Rehabilitation Act of 1973, as well as to the needs of and potential of severely disabled people through attitude training. The activities of energetic and competent disabled people will, in itself, serve to reduce the attitudinal barriers that hinder the mainstreaming of people with ) disabilities. The Vocational Rehabilitation program recognizes the importance of advocacy activities and the development of liaison relationships with consumer organizations in assuring that Vocational Rehabilitation programs are responsive to the needs of people with disabilities. Advocates will actually be a part of the local handicapped community and carry out the following activities: 1. Work with HRS Volunteer Coordinators to enlist volunteers to carry out the goals of the C.A.A.P. 2. Upon request, assist clients in acquiring VR services and in moving through the rehabilitation process. 3. Act as consultants for inquiries on accessibility in their area. Includes on-site inspection if necessary. 4. Attitude awareness training conducted by schools, churches, businesses, civic groups, etc. 5. Affirmative action training on Title V conducted for interested groups: RE: 503 for Employers, 504 for schools and social service agencies. 6. Contacting VR counselors and making them aware of the socialization and recreation resource that handicapped consumer organizations offer their clients. 7. Contacting HRS Staff Training and Development Specialist to offer assistance in providing them with appropriate information and material for training programs on disability. 8. Provide input through participation on local city and county committees addressing concerns of the disabled. 15-8 Monthly reports will provide information to the program Coordinator as to the activities undertaken and services provided by volunteer advocates in each district. Activities will be continually modified and updated as need arises. The counselor should consider the following activities relative to the Client Assistance and Advocacy Program: 1. Assuring that each client has the Agreement of Understanding explained to him/her, receives a copy of the signed Agreement of Understanding which informs him/her of the C.A.A.P. 2. If problems arise between the client and counselor which cannot be worked out, the following actions might be undertaken by the counselor or the client: a) Talk with the Vocational Rehabilitation Supervisor D) - Contact the Client Assistance and Advocacy Program for advice and assistance. (1-800-342-0778) 3. Providing employers and other interested parties with C.A.A.P.'s toll-free number for free information on tax incentives for hiring people with disabilities, tax credit for the removal of architectural barriers, and standards for mailing buildings accessible to disabled people. 4. Utilization of C.A.A.P. staff and local advocates in identifying community resources which may be of benefit to the client. In summary, limited money is forcing agencies to assess critically the services they will provide The Client Assistance and Advocacy Program can work with consumers and agency personnel to assess services and 5 when appropriate, organize and mobilize activities that will bring about programs responsive to the needs of the people they serve. 15-9 CONTRACT FOR PROFESSIONAL SERVICES BLTWLEN AND FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES VOCATIONAL REHABILITATION PROGRAM THIS AGREEMENT, entered into this day of A.D., 1978, by and between the State of Florida, Department of Health and Rehabilitative Services, Vocational Rehabilitation Program, hereinafter referred to as DHRS/VRP and ,hereinafter referred to as the "Provider". WITNESSETH: WHEREAS, there is a need to furnish client assistance and advocacy services in the community of WHEREAS, DHRS/VRP: is authorized to purchase services under Chapter 413, Florida Statutes (1973), Chapter 20, Florida Statutes, Chapter 75-48, Laws of Florida, and additionally authorized under Public Law 93-112, Section 112(a)(b). WHEREAS, DHRS/VRP IS authorized to administer Federal funds under the aforementioned Laws and Statutes of Florida, and is additionally authorized under Public Law 93-112, Section 112(a)(b), and subject to pertinent DHEW and OHD Regulations and policies applicable to Client Assistance Projects and, IT IS, THEREFORE, in consideration of the mutual undertaking and the provisions and conditions hereinafter set forth, DHRS/VRP and Provider mutually agree to the following: 1. Scope of Services The Provider will assume responsibility for the following activities: a) Upon request, assist clients in acquiring DHRS/VRP services and in moving through the rehabilitation process. b) Act as consultants for inquiries on accessibility in their area. Includes on-site inspection when necessary. c) Conduct one community attitude training session per month with use of slide tape presentation "Handicapism d) Conduct one Affirmative Action training session per month with use of slide tape presentation "Title V An Overview", for interested groups: Re: 503 for employers, 504 for recipients of federal financial assistance. e) Contacting DHRS/VRP counselors and making them aware of the socialization and recreation activities the provider offers for their clients. f) Contacting DHRS/VRP Staff Training and Development Specialists to offer assistance in providing them with appropriate information and material for statewide training programs on disability.