The North Carolina Client Assistance Program (NCCAP) is a federally mandated and funded advocacy and education program for consumers of the public rehabilitation programs (Vocational Rehabilitation Services, Services for the Blind, their Independent Living Programs, and the Centers for Independent Living).  NCCAP educates people with disabling conditions about their rights and benefits under the Rehabilitation Act of 1973 (as amended) and Title I of the ADA. We provide alternative dispute resolution (ADR) and advocacy services when applicants or consumers of the public rehabilitation programs find themselves in a conflict or disagreement with the agency. We also inform and educate consumers about agency policy, of their right to due process, and can represent consumers in that process. NCCAP is here to help educate, guide, and support people in their relationship with the public rehabilitation/independent living programs. SILC quarterly report - April 2015 1. This IL client is a 55 year-old-female who has multiple diagnoses. These include Asthma, Asperger’s, Bipolar Disorder, Ehlers-Danlos Syndrome, Fibromyalgia, Obesity, Photophobia, and TBI (frontal lobe disconnect). This woman had been employed as an attorney for a number of years until her multiple impairments made this impossible. She currently lives alone with her two dogs. She approached the Independent Living Program for assistance with modifications for her home (bathroom) so that she could perform the activities of daily living and continue to remain in her home. A number of factors made this case very challenging, and led to delays in service. She originally applied to the IL program in May of 2013. Her original IL counselor retired. The new IL counselor became ill and was out for a period of time. Communication among all parties was further hindered due to impairments related to her several conditions. The client sleeps most of the day and stays awake at night. She did not want anyone to call her during the day because the sudden noise of the phone results in severe anxiety and confusion for extended periods of time. The consumer reported that this is due to her photophobia and the frontal lobe disconnect. Related to her former profession, she frequently sent emails to her counselor, which were very lengthy and couched in a form of “legalese” which created some confusion and frustration. She also was reluctant to sign required, appropriate documents which contributed to the delay in completion of the project. The consumer also reported that she had a friend “advocate” helping her, with whom she would discuss decisions. CAP was contacted by the client in an effort to get communication and the modification project back on track. Our CAP advocate advised the parties to establish a system of email communication between CAP, IL, and the outside advocate. All parties agreed that all communication would be through email (no phone calls), and that emails to IL staff would come from the client’s friend “advocate.” A better level of trust was established, the specific tasks of the project and time lines were identified, and the process moved forward. CAP provided guidance to the client, the IL staff, and the client’s advocate and acted as a mediator between all parties. The result of our efforts is that we understand the project is moving toward completion in the next few weeks. 2. This VR/IL case involves a 28 year old female living with quadriplegia resulting from an auto accident at age three. In the course of her life, she has completed a degree in criminal justice. She receives Medicare, which usually sponsors a new wheelchair for her every five years. In 2013, while a consumer of VR services, she and her counselor determined that she was in need of a new wheelchair prior to the next Medicare approval time in 2015. VR/IL requested an exception to policy which was granted by the VR Chief of Policy so that the consumer could participate in job searching and maintain independence. The consumer was very clear in requesting a specific chair – a Quickie with the exact features to which she was accustomed. A disagreement ensued between the vendor and the consumer about the chair. The vendor did not feel her choice was safe and finally persuaded the consumer to choose another make & model. For an unknown combination of reasons, there were significant delays in providing and adjusting the chair, taking two years’ time. The client found the chair to be unsatisfactory (fitting, too wide for her vehicle, foot extensions were not calibrated correctly). She became fed up and demanded another chair. The wheelchair was finally returned to the vendor and at this time the consumer contacted CAP. Our CAP advocate began negotiations with VR to obtain the chair the consumer wanted. As so much time had elapsed, it was now possible for Medicare to cover the cost, however, the client was so frustrated that she demanded that VR pay the 20% co-pay. The VR counselor and manager denied this request, citing policy. CAP was able to advocate with the Regional Director for a policy exception. The consumer’s Quickie chair is due to be delivered to the vendor on April 1st, and should be in her possession within the following 2 weeks. The new wheelchair is the client’s choice and is described as “fire engine red” - seemingly fitting, related to this individual’s right to choose the “dangers of independence.” 3. This case involves an IL consumer who received a number of services through the IL program over time, including PAS (which he continues to receive). Recently, he contacted IL to discuss further services and he was told that IL could not provide any further services because his case had reached “the $12,000.00 limit. The consumer contacted CAP. In discussing the history of the case with the client, we surmised that the financial limit referred to by IL staff is related to home modifications, which does have a lifetime maximum expenditure. The client’s impairments are related to quadriplegia, and he uses an environmental control system to complete a number of home tasks, i.e. adjusting room temperature and the position of his bed, using the TV and phone, etc. He has had this device for some time and it is need of repair or replacement. Assistance in this purchase or repair of this device is what he is asking from IL. Our CAP advocate has just received the Release of Information from the consumer (3/24/2015) and will investigate his concerns. In our discussion of the case, we believe that the item he needs should be considered assistive technology and not a home modification. Therefore the financial cap referred to by the IL staff person should not apply. John Marens CRC, LCAS Director – NCCAP