Fiscal Year 2007 Monitoring Report on the Vocational Rehabilitation and
Independent Living Programs in the State of Alabama

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**U.S. Department of Education**

**Office of Special Education and\
Rehabilitative Services**

**Rehabilitation Services Administration**

**September 7, 2007**

contents

> Page

eXECUTIVE
SUMMARY...................................................................
3

introduction.....................................................................
5

cHAPTER 1: rEVIEW
pROCESS...................................................\... 7

cHAPTER 2: vOCATIONAL rEHABILITATION AND sUPPORTED

EMPLOYMENT PROGRAMS................................. 9

Chapter 3: Fiscal Review 24

cHAPTER 4: iNDEPENDENT lIVING Services pROGRAM............. 28

cHAPTER 5: INDEPENDENT LIVING FOR oLDER BLIND PROGRAM\.... 33

cHAPTER 6: STATUS OF ISSUES RAISED IN PREVIOUS REVIEWS....\... 37

cHAPTER 7: SUMMARY CONCLUSION........................................ 38

## Executive Summary

## 

The Rehabilitation Services Administration (RSA) reviewed the
performance of the following programs of the Rehabilitation Act of 1973,
as amended (the Act) in the state of Alabama (AL):

-   the Vocational Rehabilitation (VR) Services Program, established
    under Title I;

-   the Supported Employment (SE) Services Program, established under
    Title VI, Part B;

-   the Independent Living (IL) Services Program, authorized under Title
    VII, Chapter 1, Part B; and

-   the Independent Living Services Program for Older Individuals Who
    Are Blind (OIB), established under Title VII, Chapter 2.

## 

In Alabama, one state agency, Alabama Department of Rehabilitation
Services (ADRS), is responsible for administering the VR, SE and OIB
programs.

ADRS and the statewide independent living council (SILC) jointly
administer the IL program under Title VII, Chapter 1, part B.

RSA's review began in the fall of 2006 and ended in the summer of 2007.
During this time, RSA's AL state team:

-   gathered and reviewed information regarding each program's
    performance;

-   identified a wide range of VR and IL stakeholders and invited them
    to provide input into the review process;

-   conducted two on-site visits, and held multiple discussions with
    ADRS staff, members of ADRS' state rehabilitation council (SRC),
    staff and members of the SILC, and stakeholders to share
    information, identify promising practices and areas for improvement;

-   provided technical assistance (TA);

-   worked with ADRS and stakeholders to develop goals, strategies, and
    evaluation methods to address performance issues; and

-   identified the TA that RSA would provide to help improve program
    performance.

As a result of the review, RSA:

-   identified promising practices;

-   identified performance issues;

-   and ADRS developed performance goals and strategies related to
    selected issues;

-   identified the TA that it would provide to assist the agency to
    achieve the goals identified as a result of the review;

-   made recommendations; and

-   identified potential issues for further review.

Specifically, at the end of the review process, ADRS developed
strategies to achieve the following goals:

In the VR and SE programs, ADRS will:

-   stabilize overall agency performance expectations and reduce
    counselor caseload size;

-   increase the rehabilitation rate from 70 percent to 74.5 percent by
    FY 2010;

-   further develop the overall SE system in AL to provide the
    foundation for increasing the number of individuals who
    appropriately achieve SE outcomes; and

-   increase the strategic use of data.

In the IL program, ADRS, SILC, CILs and IL providers will:

-   strengthen the capacity of the SILC to provide the independent
    living leadership envisioned by Title VII of the Rehabilitation Act;

-   ensure that all SAILS policies and practices are fully consistent
    with the IL philosophy; and

-   obtain or leverage additional resources for the Alabama IL programs
    by maximizing collaborative efforts among all ADRS divisions.

In the OIB program, ADRS and the IL stakeholders will:

-   increase funding beyond the federal allotment;

-   leverage resources through increased collaboration; and

-   increase the number of qualified RT and O&M candidates on the state
    personnel register, and to encourage them to consider joining
    ADRS.**\
    **

[Introduction]{.underline}

Section 107 of the Rehabilitation Act of 1973, as amended, requires the
Commissioner of the Rehabilitation Services Administration (RSA) to
conduct annual reviews and periodic on-site monitoring of programs
authorized under Title I of the Act to determine whether a state VR
agency is complying substantially with the provisions of its State Plan
under section 101 of the Act and with the evaluation standards and
performance indicators established under section 106. In addition, the
Commissioner must assess the degree to which VR agencies are complying
with the assurances made in the Supplement for Supported Employment
under Title VI of the Act and programs offered under Title VII of the
Act are substantially complying with their respective state plan
assurances and program requirements.

In order to fulfill it's monitoring responsibilities, RSA:

-   reviews the state agency's performance in assisting eligible
    individuals with disabilities to achieve high-quality employment and
    independent living outcomes;

-   develops, jointly with the state agency, performance and compliance
    goals as well as strategies to achieve those goals; and

-   provides TA to the state agency in order to improve its performance,
    meet its goals, and fulfill its state plan assurances.

## Scope of the Review

RSA's reviewed the performance of the following programs of the Act:

-   the Vocational Rehabilitation (VR) Services Program, established
    under Title I;

-   the Supported Employment (SE) Services Program, established under
    Title VI, Part B;

-   the Independent Living (IL) Services Program, authorized under Title
    VII, Chapter 1, Part B; and

-   the Independent Living Services Program for Older Individuals Who
    Are Blind (OIB), established under Title VII, Chapter 2.

In addition, RSA also reviewed ADRS' progress on:

-   the agency's Corrective Action Plan (CAP) that was established as a
    result of findings from RSA's FY 2004 Section 107 monitoring review;
    and

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-   the assurance that ADRS made to RSA in conjunction with its FY 2007
    state plan.

[Alabama Administration of the VR, SE, IL, and OIB Programs]{.underline}

ADRS is governed by the AL Board of Rehabilitation Services and reports
through the Board to the Governor of Alabama. ADRS is a state agency
that is primarily concerned with vocational and other rehabilitation
needs of individuals with disabilities and is designated as the sole
state agency to administer the VR state plan. ADRS is the designated
state agency (DSA) for Alabama. ADRS operates as a combined state VR
agency. There is no designated state unit or separate agency for the
blind in Alabama.

ADRS is organized into five divisions: Vocational Rehabilitation
Service, Early Intervention, Children's Rehabilitation Service, State of
Alabama Independent Living (SAIL)/Homebound, and Administration. ADRS
provides VR, SE and OIB services through its Vocational Rehabilitation
Service Division. IL Part B services are part of the Independent Living
Services Program, one of three components SAIL.

For the four programs listed above, this report describes RSA's review
of ADRS, provides information on the agency's performance, identifies
promising practices, identifies performance issues, and identifies the
related goals, strategies, and TA that RSA will provide to ADRS to
address each of the issues identified during the review.

## Appreciation

RSA wishes to express appreciation to the representatives of the ADRS,
the SRC, the SILC, and the stakeholders who assisted the RSA monitoring
team in the review of the AL VR, SE and IL programs.

## 

## Chapter I: RSA's Review Process

## Data Used During the Review

RSA's review of the AL VR, SE, and IL programs began in the fall of 2006
and ended in the summer of 2007. RSA's data collections are finalized
and available at different times throughout the year. During this
review, RSA and the state agency used the most recent data that was
available from the FY 2005 and FY 2006 collections. As a result, this
report cites data from FY 2005 and FY 2006.

## Review Process Activities

During the review process RSA's AL state team:

-   gathered and reviewed information regarding ADRS' performance;

-   identified a wide range of VR and IL stakeholders and invited them
    to provide input into the review process;

-   conducted two on-site visits, and held multiple discussions with
    ADRS staff, SRC members, SILC members, and stakeholders to share
    information, identify promising practices and areas for improvement;

-   provided TA to ADRS;

-   worked with ADRS to develop goals, strategies, and evaluation
    methods to address performance issues;

-   made recommendations to ADRS;

-   identified potential issues for further review; and

-   identified the TA that RSA would provide to help improve the
    performance of the AL VR, SE and IL programs.

## RSA Alabama State Team Review Participants

Members of RSA's AL state team included representatives from each of
RSA's State Monitoring and Program Improvement's (SMPID's) five
functional units. The RSA AL state team was led by RSA's state liaison
to AL, Regina Luster (fiscal unit) and included: Jeff Clopein,
co-liaison (vocational rehabilitation unit), Joe Doney (technical
assistance unit), Felipe Lulli (independent living unit), and Steve
Zwillinger (data unit). Jerry Elliott (Office of Policy and Planning)
also provided assistance throughout the review process.

## Information Gathering

During FY 2007, RSA began its review of the AL VR, SE and IL programs by
analyzing information including, but not limited to, RSA's various data
collections, ADRS' VR state plan, AL's state plan for independent
living, and ADRS' SRC's Annual Report. After completing its internal
review, the RSA team carried out the following information gathering
activities with ADRS and stakeholders in order to gain a greater
understanding of the strengths and challenges of the AL VR, SE, and IL
programs:

-   conducted a series of teleconferences with VR and IL stakeholders;

-   conducted four teleconferences with the ADRS management beginning in
    February 2007;

-   conducted an on-site monitoring visit during the week of April
    16-20, 2007 and met with staff/representatives of ADRS, community
    rehabilitation programs (CRPs), ADRS Board and SRC, stakeholders,
    and the Deaf Advisory Council;

-   conducted an on-site monitoring visit during the week of June 25-29,
    2007 and met with staff of ADRS, CRPs, employers, Veteran's
    Administration Vocational Rehabilitation and Employment Program,
    Client Assistance Program, Protection and Advocacy of Individual
    Rights Program, CIL, ADRS Board, and AL Council for Developmental
    Disabilities;

-   held several teleconferences and on-site meetings focused on the SRC
    and IL services, including the development of the SILC; and

-   conducted teleconferences and held on-site meetings with the SILC
    chairperson as well as potential members to the SILC.

## Chapter 2: Vocational Rehabilitation and Supported Employment Programs

Table 1, on the page that follows, provides fiscal and program data for
fiscal years 2002 through 2006. This data provides an overview of the VR
program's costs, outcomes, and efficiency. The table identifies the
amount of funds used by the agency, the number of individuals who
applied, and the number who received services. It also provides
information about the quality of the agency's employment outcomes and
its transition services.

######### Table 1. ADRS Program Highlights, 2002 -- 2006

  ------------------ -------------- -------------- -------------- -------------- --------------
  ALABAMA            2002           2003           2004           2005           2006

  Total funds used   \$69,396,514   \$70,479,027   \$66,901,539   \$73,902,629   \$80,518,335

  Individuals served 35,755         37,127         37,286         38,383         39,629
  during year                                                                    

  Applicants         17,559         16,746         15,656         17,364         17,422

  Closed after       10,570         10,898         11,070         10,927         11,640
  receiving services                                                             

  Closed with        7,699          7,705          7,710          7,717          7,792
  employment                                                                     
  outcomes                                                                       

  Employment         7,053          7,118          7,067          7,198          7,193
  outcomes without                                                               
  supports in an                                                                 
  integrated setting                                                             

  Average cost per   \$1,940.89     \$1,898.32     \$1,794.28     \$1,925.40     \$2,031.80
  individual served                                                              

  Average cost per   \$9,013.70     \$9,147.18     \$8,677.24     \$9,576.60     \$10,333.46
  employment outcome                                                             

  Employment         110.94         109.32         115.24         104.42         96.77
  outcomes per                                                                   
  \$million spent                                                                

  Competitive        104.65         105.86         112.09         102.51         95.07
  employment                                                                     
  outcomes per                                                                   
  \$million spent                                                                

  Average hourly     \$7.70         \$7.84         \$7.92         \$8.29         \$8.41
  earnings for paid                                                              
  employment                                                                     
  outcomes                                                                       

  Average state      \$14.98        \$15.50        \$15.83        \$16.56        \$17.20
  hourly earnings                                                                

  Average hours      34.92          34.67          34.30          34.43          34.34
  worked per week                                                                
  for paid                                                                       
  employment                                                                     
  outcomes                                                                       

  Percent of         43.11          41.37          43.32          42.59          43.25
  transition age                                                                 
  served to total                                                                
  served                                                                         

  Employment rate    75.95          75.29          72.56          76.17          71.83
  for transition age                                                             
  served                                                                         

  Average time       23.90          23.70          25.00          25.90          25.60
  between                                                                        
  application and                                                                
  closure (in                                                                    
  months) for                                                                    
  individuals with                                                               
  successful paid                                                                
  employment                                                                     
  outcomes                                                                       

  Average number of  56.57          57.83          62.56          62.92          67.17
  individuals served                                                             
  per total staff                                                                
  ------------------ -------------- -------------- -------------- -------------- --------------

#######  

####### Provision of Technical Assistance to the VR and SE Programs During the Review Process

Throughout the review process RSA staff:

-   provided TA regarding general ADRS program performance based on data
    tables from FY 2005 and discussion during the RSA Data Overview
    session, including topics related to comparative performance,
    counselor workloads, resource use and staffing patterns, service
    patterns, and number and quality of employment outcomes;

-   provided TA regarding SE activities, including review of the SE
    program structure, SE performance data (based on RSA 2006 data and
    data supplied by ADRS staff), mental retardation outcome data (RSA,
    FY 2006), sources of extended funding support, SE vendor contract
    content, and discussion of SE data quality issues. This TA occurred
    as part of three meetings: a meeting with DD Council staff, a
    meeting with Greater Birmingham United Cerebral Palsy as a provider
    who served individuals using Medicaid waivers, and a specific SE
    discussion with ADRS management;

-   provided TA regarding transition, including discussion of general
    transition activities, transition staffing patterns, transition
    performance data (RSA, FY 2006), specific learning disability
    performance data (RSA, FY 2006), and consumer intake patterns
    resulting from transition activities;

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-   verified ADRS RSA-911 data while on site;

> This verification process consisted of using a custom computer
> application to compare the data reported on the RSA-911 Case Service
> Report submitted to RSA by ADRS to the actual case files including the
> original application to the agency and the Individual Plan for
> Employment. The verification process focused on 42 data elements
> reported on the RSA-911 Case Service Report. The 42 data elements
> included the date of application, gender, date of birth, race,
> ethnicity, source of referral, impairment code and cause of impairment
> for both primary and secondary impairments, weekly earning at
> application and closure, hours worked in a week at application and
> closure, primary source of support at application and closure, level
> of education attained at application and closure, employment status at
> application and closure, type of public support at application and
> closure, date of eligibility determination, date of individualized
> plan for employment, date of closure, and type of closure;

-   reviewed a non-statistical sample of 15 case files;

> Six of the records were closed in FY 2006; seven were closed in FY
> 2005; and two of the records were closed in FY 2004. For each year
> both successful and unsuccessful closures were reviewed. So much of
> the ADRS is automated that only those data elements that were reported
> on paper documents were verified.
>
> (No significant issues were identified. Minor inconsistencies between
> original case file data and final reported data (for example, a
> consistent one day delay between signing an IPE and the date it was
> entered into the case management system) were identified and
> explained.);

-   demonstrated the RSA Management Information System (MIS) to agency
    staff;

> The demonstration included how to locate the RSA-113/RSA-2 monitoring
> tables, RSA-911 monitoring tables, the standard and indicators, agency
> report cards, and the underlying report card tables. The team also
> showed agency staff how to do ad hoc queries on the MIS to obtain
> information about ADRS, and/or compare and contrast ADRS against other
> similar agencies.

-   provided staff with a general overview of QA processes, focusing on:

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-   use of performance goals and evaluative techniques;

-   other agencies' methods for approving and monitoring community rehab
    providers;

-   communication techniques in developing and monitoring QA at all
    staff levels;

-   methods of staff buy-in to QA systems and continuous quality
    processes;

-   methods for developing a coordinated QA program that involves staff,
    stakeholders, consumers, and community partners;

-   QA report dissemination;

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-   provided feedback to the agency on its case management system; and

-   reviewed and assessed selected FY 2007 State Plan attachments to
    prepare for the submittal of the FY 2008 State Plan.

####### Promising VR and SE Practices Identified by ADRS and Stakeholders During the Review Process

RSA's review process solicited input from ADRS and stakeholders about
promising practices. The following promising practices were identified:

1.  [College Preparation Programs]{.underline}

ADRS operates its College Preparation programs in 7 areas of the state.
Individuals with disabilities are referred by their VR Counselor based
on many factors, one of which is a previous vocational evaluation
indicating the potential for college success. The College Preparation
programs are held on local 2 or 4-year college campuses throughout the
state. The collaborative effort involves partnerships with Disability
Service Providers at the various post-secondary institutions, CRPs, and
university professors, with a focus on assisting the student in
developing skills to help them succeed in college. The curriculum
includes study strategies, time management skills, use of
accommodations, and education on issues related to college life,
technology and the college classroom. Over 400 students attended the
2-week summer programs across the state and successfully began college
at the completion of this summer program.

2.  [Career Preparation and Training Initiative (CPTI)]{.underline}

ADRS in partnership with local school systems, transportation agencies,
local colleges and employers, conducts a 2-week training session each
summer focusing on seniors with disabilities planning to enter the work
force following high school. Some of these individuals will choose to
enter technical training. These consumers with disabilities are
introduced to the world of work through team building activities,
employment site tours, potential employer visits, 2-year college tours,
socialization activities, and discussion topics focusing on the soft
skills associated with getting and keeping a job. This program is
community and classroom based with an emphasis on developing these
students into future workforce participants. This is the fourth summer
the program has been held with a record-high 114 referrals processed.
One key factor in CPTI's success is that each consumer's VR counselor is
required to participate, along with the consumer, in all activities.
ADRS plans to expand this service next summer to more students. This
program is being piloted in the Birmingham and surrounding areas, with
plans being made to replicate its success in other areas of the state.

3.  [Business Relations Program]{.underline}

For more than 25 years, ADRS has formally operated a business relations
program in concert with its philosophy of "dual customer," i.e.,
individuals with disabilities and employers.  To that end, a customized
program for private and public sector businesses has been designed,
delivered and tracked under a structured employer account system that
includes an agency-developed employer database. Seventeen specialty
staff of employer development coordinators (EDCs) implements this
program at the local level with the initiative spearheaded by a state
coordinator of business relations who also serves on the ADRS Executive
Leadership Team.  In support of the business relations program, ADRS
conducts in-service training for staff and affiliates (e.g. CRPs) via
its annual "Employment Institute," along with extensive specialty
training for all EDCs.  It also operates under a "Strategic Plan for
Collaboration of Employment Resources" so that there is coordinated
outreach to the business community by ADRS and its affiliates.

Acting on the philosophy of business-as-customer, ADRS incorporates
business partners from the private sector in many areas of leadership: 
the ADRS Board, SRC, several advisory committees, and through the
Alabama Business Leadership Employment (ABLE) Network.  In this
capacity, employer partners directly advise ADRS on, and participate in,
the design and implementation of services to business based on their
disability-related and employment needs.  These services include:
*recruitment services* (pre-screening, real-time electronic recruitment
of VR consumers via ABLE, job site training, post-hire follow up, no
obligation tryouts, outplacement); *technical assistance* (functional
capacity assessments, workplace modification, ergonomics, job task
analysis, product modification, accommodation implementation); *employer
training* (accommodation dialogue and solutions, interviewing do's and
don'ts, disability etiquette, identifying essential functions,
disability awareness);  *disability management* (retention services for
employees whose job is affected by illness, injury or disability);  *ADA
resources* (employment mandates, interviewing issues, reasonable
accommodations, undue burden, resources, accessibility reviews); and
*financial incentives* (assistance with tax credits and tax deductions).
Soon to be added to the list of services will be *emergency preparedness
for customers and employees with disabilities.* Annually the ADRS EDC
team of 17 works directly with more than 850 companies providing in
excess of 5,500 services to them statewide.

4.  [Adaptive Driving Training Program]{.underline}

ADRS employs a Certified Driver Rehabilitation Specialist (CDRS) to work
with individuals with physical disabilities requiring adaptive equipment
to drive independently. In addition, consumers with cognitive
disabilities are served based on need and specific disability issues.
The ADT program operates a four tier program with 4 ADRS owned vehicles
equipped with varying levels of modifications.

The first tier is evaluation, where the CDRS provides off the road and
on the road assessment of a consumer's needs as it relates to driving.
Initial assessments assist the CDRS in planning for further services.

The second tier is training. Provided the consumer moves through the
assessment process successfully, a prescriptive number of hours are
recommended for training.

The third tier is licensure where those consumers who require updated
licensing or new licensing will complete the licensure requirements
through a partnership with Alabama Department of Public Safety and ADRS.
ADRS actually conducts the road test with the consumer in the adapted
vehicle and issues a report that is accepted for licensing purposes by
the Alabama Department of Public Safety. ADRS staff is trained to
provide the same road test and driving activities required of all other
license applicants.

The fourth tier is modification where the consumer\'s vehicle is
equipped, reviewed and finalized by the CDRS. While ADRS does not
purchase vehicles, ADRS has relationships with auto manufacturers in
which the vehicle can be ordered with features like dropped floors and
overhead wiring, significantly reducing the costs of structural
modifications to the vehicle. ADRS also negotiates fee schedules for
modifications with vendors each year, making costs more predictable.

Services through this program are provided statewide in the consumer\'s

home area. RSA staff believes that the relationships with manufacturers,
negotiated vendor fees, and the relationship with the Alabama Department
of Public Safety are particularly noteworthy.

####### VR and SE Issues Identified by ADRS and Stakeholders During the Review Process

RSA's review process solicited input from ADRS and stakeholders about VR
and SE performance and compliance issues. The following issues were
identified throughout the review process:

-   The anticipated or realized impact on consumers of losing
    experienced VR counselors.

-   Dealing with emerging disabilities (e.g., autism), serving
    underserved populations (e.g., latinos), and providing services to
    an aging population.

-   The role of Quality Assurance (QA) needs to be strengthened,
    starting by examining the tools and systems utilized by other state
    agencies in expanding the traditional role of QA throughout the VR
    process.

-   Expansion of outreach efforts is needed in the medical community for
    VR and IL programs to ensure reaching all potential consumers
    exiting hospitals in all areas of the state.

-   Expansion of SE services for students reaching the age of 21 and
    the connection to resources and ongoing support for clients exiting
    the school system; ADRS needs consistent connection and outreach to
    community resources beyond the existing supported employment
    projects; funding to serve the most severe clients in need of SE
    services; and consistent interagency coordination across the state.

-   The need to serve more consumers who are in the most severe category
    in order to address the impression that to meet yearly goals,
    counselors prefer to work with job ready clients only; significant
    cognitive services are not available in the communities; autism
    cases/numbers are increasing and concerns were raised that services
    are unavailable and/or limited.

-   VR counselor caseloads are too large (250 +) for counselors to
    effectively work with consumers and there are not enough support
    services throughout the state.

-   Concerns were raised related to the quality of job placement
    services for consumers completing college degree programs.

-   There is a need for basic sign language training and more certified
    interpreters on ADRS' staff.

-   Consumers need more opportunities for federal and state placements
    and internships with employers.

-   The timeliness of obtaining equipment or van modifications.

Following compilation and discussion with ADRS about the issues, RSA
worked with ADRS to address as many of these issues as possible either
directly or by consolidating the issue into a broader issue area.

## 

## VR and SE Performance Issues, Goals, Strategies, and Technical Assistance 

RSA and ADRS agreed on the following performance goals; strategies to
achieve those goals, and TA that RSA would provide to assist ADRS
achieve each goal. These goals and strategies will be considered for
inclusion in ADRS' FY 2009 state plan and if they are included, progress
on achieving these goals will be reported in ADRS' FY 2011 annual state
plan submission.

1.  [ADRS Resources]{.underline}

[Issue]{.underline}: In general, ADRS takes more applications, serves
more individuals and achieves more employment outcomes than other
general and combined agencies, taking into account state population and
funds available. See the Table 2.

**Table 2. ADRS Outcomes (FY 2006)**

  -------------------------------------------------------------------------
  Measure              ADRS             Mean for all      Median for all
                                        general and       general and
                                        combined VR       combined VR
                                        agencies          agencies
  -------------------- ---------------- ----------------- -----------------
  Applicants/million   3,371            2,363             2,325
  population                                              

  Applicants per       208              188               189
  million dollars                                         
  spent                                                   

  Competitive          1,662            805               685
  Employment outcomes                                     
  per million                                             
  population                                              

  Competitive          103              62                60
  Employment Outcomes                                     
  per million dollars                                     
  spent                                                   

  Eligible cases on    6,233            3,462             3,221
  hand per million                                        
  population                                              

  Number receiving     519              302               292
  services under an                                       
  IPE during the year                                     
  per million dollars                                     
  spent                                                   
  -------------------------------------------------------------------------

These outcomes are compelling, however, they appear to be straining the
service delivery system. This appears to be true for the basic VR field
program in terms of the VR counselor caseloads as well as for the
programs that provide services to the individuals on the caseloads, such
as the rehabilitation engineering services, the employer development
program, vocational evaluation services, and others.

This effect is most easily documented for VR counselors. While RSA data
indicates that the average AL VR counselor (VRC) served 189 cases,
actual caseload size varies greatly by the type of assignment and the
location of the position. Most VR counselor caseloads were described as
being between 250 and 350 per counselor, with the highest in the state
at the time we visited at over 600 cases. These numbers are extremely
high. The average caseload size for general and combined agencies is a
little over 100 cases per counselor, although there is considerable
variation within a state and between states. Likewise, ADRS has very
high expectations of counselors in terms of employment outcomes and
cases served. Counselors frequently cited employment outcome
expectations of more than 50 per year. Such goals (and even higher
expectations) were not uncommon prior to and shortly after the passage
of the Rehabilitation Act of 1973. However, agency expectations for
employment outcomes for counselors are more commonly in the 20's and
30's and occasionally the 40's under the provisions of the
Rehabilitation Act.

It is likely that the caseload size affects the timeliness and quality
of case services. Comments to this effect were occasionally made by
stakeholders, and during the review some students in the college prep
program told the review team that that they either did not know their
counselor or had very little contact with them. Counselors and
supervisors acknowledged in interviews that the workload was
overwhelming.

Counselors and supervisors indicated that the large workload could
inadvertently complicate aspects of the service delivery system. For
example, one counselor opened her transition caseload students in the
tenth grade rather than the more common practice of opening formal cases
for students in the eleventh grade because of the one to two year wait
to get a vocational evaluation from Lakeshore Rehabilitation Facility.
The counselors perceived few quality vocational evaluation resources
outside of Lakeshore Rehabilitation Facility and Easter Seals of
Homewood, especially in the rural areas of the state, and the six
vocational evaluators were scheduled for years in advance with some, but
relatively little, flexibility for emergencies. Similar stories were
told relative to the ADRS employment program and the
rehabilitation-engineering program. Overload in the support programs
cannot be corroborated through RSA data, as the national databases lack
sufficient detail, but there was consistent agreement about the
difficulty in getting these kinds of support services. For this reason,
RSA suggests that the general process that is applied below to stabilize
and reduce counselor caseload size be considered for determining the
need for other service delivery program staff as well.

One of the reasons that it may be possible for Alabama to have some
impact on reducing the overloaded system is that ADRS does have a
significant number of FTEs, currently a total of 610. Of these, 241 are
reported as counseling and guidance staff, but only about 163 are
actually caseload carrying counselors. The FY 2005 RSA-2 report showed
325 support staff. Reviewing the current use of staff resources may show
some areas where resources could be redirected to the field program.

[Goal]{.underline}: Stabilize overall agency performance expectations
and reduce counselor caseload size.

Strategies:

-   study the current counselor staffing structure with respect to
    caseload size, employment outcome expectations, and the effects of
    type of caseload assignment and location of assignment on workload.

-   review the current agency staffing pattern to determine if the
    current staff allocations are still appropriate, and if not
    appropriate, identify resources that could be redirected to the
    field program.

-   hire additional counselors through SMART BUDGET appropriations
    requests. (2 VRC positions were requested and approved in the FY
    2008 budget, and 10 will be requested in the FY 2009 budget
    request).

## Methods of Evaluation:

-   Develop a plan for distribution or redistribution of staff
    resources, taking into account resources currently available for
    redistribution and any additional positions approved by December
    31, 2007. This plan should contain specific steps, timelines and
    measurable objectives for the implementation of resource
    distributions that would increase counselor positions in the field,
    maintain but not increase the current level of ADRS performance, and
    decrease the overall performance expectations for individual
    counselors commensurate with the increase in resources.

-   Add specific steps, timelines and measures to the FY 2009 State Plan
    submission for RSA and ADRS monitoring purposes.

## Technical Assistance:

-   RSA staff can assist with the development of models to readjust
    performance expectations and project how performance might change as
    staff is added.

-   RSA can help identify if there are other agencies that have gone
    through similar processes or are particularly good at taking into
    account multiple variables in estimating performance outcomes.

2.  [Rehabilitation Rate]{.underline}

Issue: Improve the percentage of individuals receiving services under an
IPE who achieve an employment outcome (the rehabilitation rate).

ADRS has historically had a rehabilitation rate that exceeded 70
percent. This rate exceeds the national average by about 10 percent.
However, ADRS has set for itself the challenging goal of increasing an
already high rehabilitation rate and is committing itself to this goal
through the State of Alabama's SMART BUDGET process. If ADRS is
successful in reducing the very large counselor caseload size as
discussed in issue 1 above, it is possible that the additional time that
becomes available to counselors can be used for better planning and
increased follow-up so that a general decrease in the number of cases
served per counselor could lead to a higher success rate with the
individuals served by each counselor.

There are several reasons that ADRS gives for selecting this goal.
Foremost is that individuals who do not achieve an employment outcome
after receiving services under an IPE are individuals with whom the
agency has established a relationship and has invested time and
resources toward achieving an employment outcome, and the job is not
done. In addition to being the right thing to do for the individual, it
is also the right thing to do to maximize the effectiveness and
efficiency of the VR program by maximizing the investment already made
in the individual. Finally the rehabilitation rate is one of the RSA
performance indicators (indicator 1.2) under Section 106 of the
Rehabilitation Act.

Goal: Increase the rehabilitation rate from 70 percent to 74.5 percent
by FY 2010.[^1]

Strategies:

-   Review status 28 closures to identify reasons for unsuccessful
    outcomes, and continue to review these cases as part of QA
    activities.

-   Consider requiring one or more process requirements such as
    supervisory review of 28 cases prior to closure, requiring multiple
    contact numbers at application to provide more points of contact if
    the individual cannot be located at the primary address, or
    establishing minimum requirements for regular personal contact. The
    particular type of process requirement should be determined by the
    status 28-closure review discussed above.

-   Identify population needs of groups more likely to be unsuccessful
    in achieving an employment outcome and provide staff training and/or
    services to address needs. Possible examples might be to develop
    training and services for emerging disability populations such as
    autism, culturally relevant approaches to the growing Hispanic
    population, and development of a focus on serving older workers who
    do not wish to retire but are aging into disability.

-   Reduce caseload size using approach outlined under the goal of
    reduction of caseload size and performance expectations.

Method of Evaluation:

-   Overall method of evaluation is the achievement of a rehabilitation
    rate of 74.5 percent in FY 2010 based on the results of ADRS
    casework activity as reported on the RSA 113 report.

-   To develop measurable intermediate steps related to the particular
    strategies outlined above, develop by March 31, 2008, a plan for
    implementing these strategies that should include a description of
    the main reasons found for unsuccessful employment outcomes; any
    process requirements that will be implemented and the timeframes and
    measurable results expected from the implementation of the
    requirement; and, identification of particular groups of individuals
    for which staff training or customized services are needed to
    improve outcomes, including the timelines for implementation and
    outcome improvement expectations for the activities. These
    measurable objectives should be included in the ADRS FY 2009 state
    plan submission.

## Technical Assistance:

-   RSA staff can assist with the development of information about
    rehabilitation rates for groups that can be identified on the
    RSA-911 to determine populations found to be at risk in the national
    data.

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-   RSA can help identify other agencies that have implemented
    activities similar to those being considered by ADRS to improve the
    rehabilitation rate, or, that appear to be successful with
    particular groups of individuals.

3.  [Supported Employment]{.underline}

[Issue]{.underline}: Efforts need to be made to improve the Alabama SE
system in order to expand the availability of extended employment
support services and as a result improve ADRS' provision of SE services.

Alabama serves a high proportion of individuals with cognitive
impairments, 3,215 of 7,792, or 40.55 percent of employment outcomes are
individuals with cognitive impairments, while the national average is
27.28 percent. Individuals with mental retardation comprise 33 percent
(1,083) of the cognitive impairment group. Individuals with psychosocial
impairments made up 13.85 percent (1,079 of 7,792) of employment
outcomes and individuals with other mental disorders made up 9.21
percent (718 of 7,792) of employment outcomes.

These groups are more likely to need supported employment than other
disability groups. However, RSA 911 data reported by ADRS indicates that
only 280 individuals were closed with an SE outcome in FY 2005. This is
a relatively small number, considering the high number of individuals
served who have mental retardation or psychosocial impairments as
disabling conditions, and considering that 2,244 individuals received
on-the-job support services as part of their IPE.

In discussion, ADRS indicated that they had data showing higher numbers
of individuals with SE outcomes, and provided numbers ranging from just
under 400 to about 450 individuals who achieved a supported employment
outcome. Various factors relating to how these counts were obtained were
discussed. However, even accepting the highest value, ADRS SE outcomes
are relatively low.

One reason for this appears to be a relatively undeveloped system of
long-term support after VR services in Alabama since Alabama uses the
Medicaid waiver option, but only for individuals with mental
retardation. The state does not extend the waiver to other individuals
with developmental disabilities or to individuals with severe and
chronic mental illness.

Goal: Further develop the overall SE system in AL to provide the
foundation for increasing the number of individuals who appropriately
achieve SE outcomes.

Strategies:

-   Resolve data discrepancies and consistently count and report SE
    outcomes.

-   Meet with senior management of the state developmental disability
    and mental health agencies for the purpose of discussing the current
    employment programs of these agencies and to determine how these
    agencies use supported employment with their populations, including
    identification of barriers to supported employment for their
    populations.

-   Meet with the state Medicaid agency to make inquiries about and/or
    advocate for the extension of the Medicaid waiver to groups other
    than those with mental retardation that would be likely to benefit
    from supported employment services.

Method of evaluation:

-   Provision of information to RSA that identifies discrepancies in
    counting SE employment outcomes and provides a plan to make SE
    outcome reporting consistent across reporting systems.

-   Document contacts made with, at minimum, the Alabama DD agency, the
    Alabama mental health agency, and the Alabama Medicaid agency
    regarding possible use of Medicaid waivers for extended support for
    individuals needing employment supports.

-   Other contacts should be documented as necessary to investigate the
    possibility of waiver extension.

4.  [Strategic Use of Data]{.underline}

## 

## Issue: ADRS manages a diverse and complex enterprise. ADRS reviews, analyzes and reports to stakeholders ADRS' outcomes, progress and goals. ADRS lacks a consistent process to graphically depict data as a common tool in managing programs and processes.

ADRS faces the challenge of transforming large amounts of data into
readily usable information.

ADRS will benefit from enhancing their analysis and reporting (including
graphical reporting) of program data. With enhanced data procedures,
including the appropriate use of graphs and tables to highlight data, it
will be easier for ADRS to compile data, to gain increased understanding
from data and to use data to help effective decision-making.

[Goal]{.underline}:  Increase the strategic use of data.**\
**

In order to increase agency effectiveness in presenting data to external
and internal audiences, ADRS may wish to consider the following:

-   Identify key stakeholders and the types of information and the
    presentation format they need.

-   Create standardized data reporting tools and formats across ADRS
    programs so that:

> \- reporting formats are consistent across agency activities; and
>
> \- reporting formats are appropriate to the specific purpose being
> addressed.

-   Use standardized agency measures for tracking agency progress and
    program progress.

-   Develop evaluation strategies and models using program outcome data
    to compare ADRS programs' results over time and with other ADRS
    programs.

-   Create a standard template for reporting to state government
    offices.

The use of a standardized set of report templates may ease staff burden
in creating custom charts and tables for reporting program outcomes.

# Strategies: 

-   Develop report templates, including graphics, for ADRS program
    reporting.

-   Develop report templates, including graphics, for ADRS agency level
    reporting.

-   Develop a multi-year plan for staff development for providing ADRS
    staff with skills and tools for analyzing and graphically presenting
    data to aid decision-making and to guide program improvement
    decisions.

Technical Assistance:

-   ADRS will explore local resources for staff development.

-   RSA will provide TA in data quality including reporting and
    analytical techniques to support agency operations.

## VR and SE Issues for Further Review

RSA plans on conducting further review of the following SE issues:

[Issue]{.underline}: The SE Milestone CRP contracts.

As mentioned in the section relating to the goal of increasing SE
outcomes, ADRS appears to get relatively few SE employment outcomes,
even accounting for data reporting discrepancies. Alabama can use the
Medicaid waiver option only to provide employment support to individuals
with mental retardation, and does not provide extended support to
individuals with other developmental disabilities or severe and chronic
mental illness.

ADRS contracts with CRPs to provide SE services and obtain SE employment
outcomes through the Milestones Program, which is essentially a
performance-based contract system where payments are made when
particular benchmarks (called milestones) are reached. The definition of
each milestone and the expectations of the parties are well defined and
clearly laid out in the contract.

However, Title I regulations at 34 CFR 361.46(b)(3) and Title VI
regulations at 34 CFR 363.20(g)(3)(i) both require the following, quoted
from 34 CFR 361.46(b)(3).

An IPE for an individual with a most significant disability for whom an
employment outcome in a supported employment setting has been determined
to be appropriate must\--...

> *"(3) Identify the source of extended services or, to the extent that
> it is not possible to identify the source of extended services at the
> time the IPE is developed, include a description of the basis for
> concluding that there is a reasonable expectation that those sources
> will become available..."*

ADRS includes in the Milestone contract related to SE services a
provision that CRPs are responsible for finding the source of extended
support. This provision appears to pass the requirement that the state
VR agency identify the actual or possible sources of extended support to
CRPs.

RSA will review the appropriateness of meeting the regulatory
requirements of identifying a reasonable likelihood of the availability
of extended support services through a contract that requires CRPs to
provide extended services, possibly without reimbursement.

[Chapter 3: Fiscal Review of the VR Program]{.underline}

RSA reviewed ADRS' fiscal management of the VR program. During the
review process RSA provided TA to the state agency to improve its fiscal
management and identified areas for improvement. RSA reviewed the
general effectiveness of the agency's cost and financial controls,
internal processes for the expenditure of funds, use of appropriate
accounting practices, and financial management systems.

The data in the following table, taken from fiscal reports submitted by
the state agencies, speak to the overall fiscal performance of the
agency. The data related to matching requirements are taken from the
fourth quarter of the respective fiscal year's SF-269 report. The
maintenance of effort (MOE) requirement data are taken from the final
SF-269 report of the fiscal year (two years prior to the fiscal year to
which it is compared). Fiscal data related to administration, total
expenditures, and administrative cost percentage are taken from the
RSA-2.

**Table 3**

**Fiscal Data for ADRS for FY 2002 through FY 2006**

  ----------------------------- ------------ ------------ ------------ ------------ ------------
  **Alabama (C)**                                                                   

  **Fiscal Year**               **2002**     **2003**     **2004**     **2005**     **2006**

  **Grant Amount**              52,055,981   52,930,173   54,054,418   55,445,837   55,857,717

  **Required Match**            14,088,849   14,325,447   14,629,722   15,006,307   15,117,781

  **Federal Expenditures**      50,440,964   51,263,359   47,182,542   49,070,045   54,862,474

  **Actual Match**              14,213,849   14,450,447   14,754,722   14,671,205   15,242,781

  **Over (Under) Match**        125,000      125,000      125,000      (335,102)    125,000

  **Carryover**                 1,615,017    1,666,814    6,871,876    6,375,792    995,243

  **Program Income**            2,260,873    1,058,029    1,788,021    1,138,857    2,003,725

  **Maintenance of Effort       13,406,992   13,699,847   14,213,849   14,450,447   14,754,722
  (MOE)**                                                                           

  ** **                                                                              

  **Administrative Costs**      3,448,425    3,982,241    4,074,406    4,332,566    5,071,650

  **Total Expenditures**        69,396,514   70,479,027   66,901,539   73,902,629   80,518,335

  **Percent Admin Costs to      4.97%        5.65%        6.09%        5.86%        6.30%
  Total Expenditures**                                                              
  ----------------------------- ------------ ------------ ------------ ------------ ------------

[Explanations Applicable to the Fiscal Profile Table]{.underline}

[Grant Amount:]{.underline} The amounts shown represent the final award
for each fiscal year, and reflect any adjustments for MOE penalties,
reductions for grant funds voluntarily relinquished through the
reallotment process, or additional grant funds received through the
reallotment process.

[Match (Non-Federal Expenditures)]{.underline}: The non-Federal share of
expenditures in the Basic Support Program, other than for the
construction of a facility related to a community rehabilitation
program, was established in the 1992 Amendments to the Rehabilitation
Act at 21.3 percent. As such, a minimum of 21.3 percent of the total
allowable program costs charged to each year's grant must come from
non-Federal expenditures from allowable sources as defined in program
and administrative regulations governing the VR Program. (34 CFR
361.60(a) and (b); 34 CFR 80.24)

In reviewing compliance with this requirement, RSA examined the
appropriateness of the sources of funds used as match in the VR Program,
the amount of funds used as match from appropriate sources, and the
projected amount of state appropriated funds available for match in each
federal fiscal year. The accuracy of expenditure information previously
reported in financial and program reports submitted to RSA was also
reviewed.

[Carryover]{.underline}: Federal funds appropriated for a fiscal year
remain available for obligation in the succeeding fiscal year only to
the extent that the VR agency met the matching requirement for those
federal funds by September 30 of the year of appropriation. (34 CFR
361.64(b)) Either expending or obligating the non-federal share of
program expenditures by this deadline may meet this carryover
requirement.

In reviewing compliance with the carryover requirement, RSA examined
documentation supporting expenditure and unliquidated obligation
information previously reported to RSA to substantiate the extent to
which the state was entitled to use any federal funds remaining at the
end of the fiscal year for which the funds were appropriated.

[Program Income]{.underline}: Program income means gross income received
by the state that is directly generated by an activity supported under a
federal grant program. Sources of state VR program income include, but
are not limited to, payments from the Social Security Administration for
rehabilitating Social Security beneficiaries, payments received from
workers' compensation funds, fees for services to defray part or all of
the costs of services provided to particular individuals, and income
generated by a state-operated community rehabilitation program. Program
income earned (received) in one fiscal year can be carried over and
obligated in the following fiscal year regardless of whether the agency
carries over federal grant funds. Grantees may also transfer program
income received from the Social Security Administration for
rehabilitating Social Security beneficiaries to other formula programs
funded under the Act to expand services under these programs.

In reviewing program income, RSA analyzed the total amount (as compared
to the total percentage of income earned by all VR agencies and
comparable/like VR agencies), sources, and use of generated income.

[Maintenance of Effort (MOE)]{.underline}: The 1992 Amendments revised
the requirements in section 111(a)(2)(B)(ii) of the Act with respect to
maintenance of effort provisions. Effective Federal FY 1993 and each
Federal fiscal year thereafter, the maintenance of effort level is based
on state expenditures under the title I State plan from non-federal
sources for the federal fiscal year two years earlier. States must meet
this prior year expenditure level to avoid monetary sanctions outlined
in 34 CFR 361.62(a)(1). The match and maintenance of effort requirements
are two separate requirements. Each must be met by the state.

In reviewing compliance with this requirement, RSA examined
documentation supporting fiscal year-end and final non-federal
expenditures previously reported for each grant year.

[Administrative Costs]{.underline}: Administrative costs means
expenditures incurred in the performance of administrative functions
including expenses related to program planning, development, monitoring
and evaluation. More detail related to expenditures that should be
classified as administrative costs is found in VR Program regulations at
34 CFR 361.5(b)(2).

####### Provision of Technical Assistance to the VR and SE Programs During the Review Process

As part of the fiscal review of ADRS, RSA:

-   provided a synopsis of each requirement and reviewed with financial
    staff RSA's assessment of the agency's compliance with specific
    financial requirements -- match, maintenance of effort (MOE),
    carryover, reallotment, program income, liquidation of outstanding
    obligations and grant closeout;

-   conducted 1 day of intensive financial management training with new
    financial staff (including ADRS' internal auditor), with topics
    covering: the VR Program formula, the allotment process and program
    cost of living increases, match/overmatch, maintenance of effort,
    carryover, grant period, liquidation of obligations, grant closeout,
    prior approval requirements, program income, allowable costs,
    guidance and reference materials, financial reports, reallotment and
    establishment authority;

-   reviewed the State of Alabama's SMART budget process, ADRS' goals
    for FYs 2007 -- 2009 and ADRS' designation as a high-performing
    agency, resulting in ADRS receiving an additional \$524,124 in FY
    2008 for the salaries and case services budgets for two additional
    rehabilitation counselors, with a goal to raise the rehabilitation
    rate from 70 to 75 percent;

-   RSA also discussed formulating measurable goals and strategies for
    using the SMART budget process for additional VR Program funding and
    program expansion activities;

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-   reviewed sources and sufficiency of FY 2007 match and projected
    resources for FY 2008 and reviewed strategies for managing the
    maintenance of effort requirement;

-   determined the level of additional funds that can be matched if
    requested and received through the reallotment process;

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-   provided an overview of RSA's Management Information System and
    reviewed with staff the status of all formula grant program report
    submissions for FYs 2003 -- 2007;

-   Approved complete reports;

-   toured the new state office complex and reviewed with financial
    staff the projected costs associated with ADRS' upcoming move,
    funding sources for the purchase of the new complex, renovation and
    equipment requirements and costs, allowable costs that can be borne
    by the VR Program, and the anticipated impact on the agency's
    service delivery budget over the next two fiscal years; and

-   reviewed expenditures reported on the RSA-2, "Annual Vocational
    Rehabilitation Annual Program/Cost Report", with specific emphasis
    on administrative costs (Note: ADRS' overall administrative costs
    are considerably lower than the national averages for all VR
    agencies and combined agencies \[4-5 percentage points\] and these
    costs appear to be reported correctly and may be the result of ADRS
    being a free-standing agency, with minimal additional state
    government overhead layers being charged to RSA-funded programs.)

######## Chapter 4: IL Services Program

[Program Organization]{.underline}

ADRS received \$301,477 in Part B funds for its FY 2007 State of Alabama
Independent Living Services (SAILS) program. ADRS provides IL services
in Alabama directly, utilizing a combination of Part B federal funds and
state funds. The SAILS program provides IL services in all 67 counties
in Alabama through seven IL specialists housed at ADRS field offices.
Because of the rural nature of the state, the IL specialists provide
services on an itinerant basis, mostly at the individuals' homes and
communities.

In addition to the Part B IL program, ADRS manages the IL Homebound
program and the Medicaid Waiver Programs, two state programs that assist
Alabama\'s citizens with the most significant disabilities to live in
their homes through the provision of personal assistance services,
counseling services, home modifications, medical supplies and durable
medical equipment.

**Table 4**

**FY 2006 ADRS IL Program Highlights**

  ------------------------------------------------ ----------------------
                                                   Amounts of Funding

  Part B Funds                                     301,477

  Older Blind                                      498,782

  Other Federal Funds                              0

  State Funds                                      0

  Local Government                                 33,497

  Private/Other Funds                              0

  Total                                            833,756
  ------------------------------------------------ ----------------------

####### Provision of Technical Assistance to the IL Program During the Review Process

RSA provided TA to ADRS in a number of IL program areas during the
review process, including:

-   SILC membership and composition requirements;

-   ADRS and Alabama SILC roles and responsibilities;

-   State Plan for Independent Living (SPIL) development; and

-   Annual Performance (704) Report development.

At the start of the review RSA found that the SILC was not fully
constituted in accordance with the Act. The SILC members' terms had
expired and the governor had not reappointed them. The review team
immediately informed ADRS and the SILC that RSA could not accept or
approve Alabama's SPIL if the SILC were not fully constituted. With TA,
the required SILC appointments were secured and the SPIL was duly
submitted by ADRS and a fully constituted SILC.

RSA provided TA regarding SPIL goals and objectives, outreach to
unserved and underserved areas; input from centers for independent
living (CILs) and the general public; statewide IL needs assessment;
SILC resource plan; and the SPIL evaluation plan.

####### Promising IL Practice Identified by ADRS and Stakeholders During the Review Process

RSA's review process solicited input from ADRS and stakeholders about
promising practices. The following promising practice was identified:

ADRS' seven independent living specialists are able to cover the whole
state of Alabama, including large rural areas, through an
entrepreneurial service provision approach. IL specialists leverage
their fixed annual service provision budget by generating local
donations of additional goods and services for their consumers. A total
of \$527,000 in donated goods and services were reported in FY 2006.
Additionally, IL specialists promote the IL philosophy and promote
awareness about IL issues and services through public appearances and
relationship-building activities involving local community
organizations, state agencies, hospitals, rehabilitation facilities,
individual families and CILs.

####### IL Issues Identified by ADRS and Stakeholders During the Review Process

RSA's review process solicited input from ADRS and stakeholders about IL
performance and compliance issues. The following issues were identified:

-   Federal IL funding is not keeping up with growing demands for IL
    services.

-   ADRS and the CILs face challenges in providing access to IL services
    in the large rural areas of the state.

-   ADRS faces challenges in recruiting and retaining IL specialists due
    to limited funding;

-   The SILC has experienced challenges in recruiting and maintaining
    the active involvement of members.

Following compilation of this list, RSA worked with ADRS to address as
many of these issues as possible either directly or by consolidating the
issue into a broader issue area.

## 

## IL Performance Issues, Goals, Strategies, and Technical Assistance 

As a result of the review, RSA and ADRS agreed on the following IL
performance goals, strategies to achieve those goals, and TA that RSA
would provide to assist ADRS achieve each goal.

1\. [SILC Leadership]{.underline}

Issue: RSA found that the Alabama SILC was not fully exercising its
leadership role due to an incomplete understanding of the SILC's
statutory roles and responsibilities and the difficulty in maintaining
adequate levels of member involvement in SILC activities.

Goal: To strengthen the capacity of the SILC to provide the independent
living leadership envisioned by Title VII of the Rehabilitation Act.

Strategies:

-   The SILC will assess its training needs by using the self-assessment
    tool, "What Every SILC Member Should Know," at least once a year.

-   ADRS and the SILC will provide the SILC with training on the IL
    philosophy and the law regarding independent living, especially for
    newly appointed members.

-   ADRS and the SILC will explore ways to increase attendance at SILC
    quarterly meetings.

-   The SILC will make suggestions regarding the creation of a co-chair
    or vice-chair position to act on behalf of the chair when absences
    occur.

-   The SILC will develop and implement systems for tracking members'
    term dates and appointment status and for identifying and nominating
    prospective SILC members.

-   ADRS and the SILC will establish a mechanism for periodically
    assessing the SILC's funding needs to ensure that the SILC resource
    plan adequately addresses the resource needs of the SILC for the
    fulfillment of its statutory roles and responsibilities.

Methods of Evaluation:

-   A subcommittee will develop a SILC resource reassessment plan,
    including evaluation criteria and timelines, by December 31, 2007*.*
    The mechanism will take into account the timelines for public
    hearings if the reassessment were to result in a SILC resource plan
    modification requiring a SPIL amendment.

-   The SILC will complete the review and revision of its SILC by-laws,
    policies and procedures by December 31, 2007.

-   The SILC will complete the assessment of SILC training needs and
    available training resources by December 31, 2007.

-   A subcommittee will complete the review and revision of the SILC's
    promotional materials by June 30. 2008.

-   SILC membership will increase from 17 to 22 members by September 30,
    2008**.**

Technical Assistance: RSA will provide training and TA as needed,
including reviewing any draft revised SILC by-laws, policies, procedures
and public information materials.

2\. [SAILS program consistency with the IL philosophy]{.underline}

Issue: SAILS' policies, procedures and case management practices are
largely consistent with the IL philosophy and the four core services.
During the on-site review, however, RSA discussed with ADRS staff
specific areas for improving the wording of certain policy and
procedures statements and of certain IL goal setting and case closure
practices in the consumer service records.

Goal: To ensure that all SAILS policies and practices are fully
consistent with the IL philosophy.

Strategies:

-   Review and revise SAILS' policies, procedures and practices, as
    necessary.

-   Provide ADRS IL specialists with the corresponding training, as
    necessary.

-   Review and enhance SAILS' QA system for IL services.

Methods of Evaluation:

-   ADRS will complete the review and revision of the SAILS policies,
    procedures and practices by March 31, 2008.

-   All IL specialists will be trained on the revised policies and
    procedures by June 30, 2008.

Technical Assistance: RSA will provide training and TA as needed,
including reviewing any draft policies and procedures revisions.

3\. [Resource development]{.underline}

Issue: ADRS and other stakeholders told RSA that federal funding for the
IL program is not keeping up with growing demands for IL services in
Alabama, especially in the context of the aging population and the
state's large rural areas. Alabama's FY 2008-2010 SPIL includes an
objective for identifying three new funding sources for the IL programs.

Goal: Obtain or leverage additional resources for the Alabama IL
programs by maximizing collaborative efforts among all ADRS divisions.

Strategies:

-   Provide cross-training for EDCs and work collaboratively with the
    EDCs and job coaches to identify consumers who would benefit from IL
    available services in support of their employment goals.

-   Develop strategies with VR, Older Alabamians System of Information
    and Services (OASIS), Early Intervention (EI) and Children's
    Rehabilitation (CRS) staff to provide services to unserved and
    underserved populations.

-   Provide education to VR counselors, EI staff, and CRS staff at the
    local levels to increase knowledge of IL services available through
    the SAIL program.

-   Promote collaboration on youth transition by continuing to attend
    Teen Transition Clinics routinely at all locations throughout the
    state and by establishing contacts at local education agencies that
    will allow for provision of IL services to students in transition.

-   Explore the possibility of developing and presenting any of these
    joint strategies or activities as an innovative pilot project for
    possible funding through the SMART budget process.

-   Involve the CILs in the applicable strategies and activities
    discussed above, as appropriate.

-   Provide SAIL, OASIS and CIL staff cross training for implementing
    the joint strategies and activities.

Method of Evaluation: A workgroup consisting of representatives from
SAILS, OASIS, CILs, the SILC and other ADRS divisions will present its
recommendations for new collaborative initiatives, including a possible
SMART budget pilot project proposal, by June 30, 2008.

Technical Assistance: RSA will provide the Alabama IL partners with TA
upon request and may propose additional collaborative opportunities in
areas such as pre-vocational skills training, assistive technology and
transition from institutions.

[Chapter 5: OIB Program]{.underline}

[Program Organization]{.underline}

ADRS received \$498,782 in OIB funds for its FY 2006 OIB program, the
OASIS. ADRS' Deaf and Blind Services (DBS) manage the program.
Rehabilitation teachers (RTs) and Orientation and Mobility (O&M)
specialists provide IL services primarily at consumers' homes and
communities, based on an itinerant model of service delivery. This model
enables the RTs and O&M specialists to reach blind and visually impaired
consumers in rural areas of the state where public transportation
options are especially limited. In addition to serving individual
consumers, the RTs cultivate relationships with local leaders and
organizations to leverage community resources and to increase awareness
about OASIS program.

####### Provision of Technical Assistance to the OIB Program During the Review Process

RSA provided TA to ADRS in a number of OIB program areas during the
review process, including:

-   alternative resource development and leveraging strategies;

-   collaborative ideas involving the OASIS, SAILS and CILs programs;
    and

-   State Plan for Independent Living (SPIL) development and evaluation.

####### Promising OIB Practices Identified by ADRS and Stakeholders During the Review Process

RSA's review process solicited input from ADRS and stakeholders about
promising practices. The following promising practices were identified:

1.  [Quality Assurance]{.underline}: OASIS monitors, evaluates and
    ensures quality OIB services and outcomes through a variety of
    integrated approaches and tools such as:

-   an annual third-party evaluation conducted by Mississippi State
    University (MSU) and consumer satisfaction survey provided
    automatically to every OASIS consumer upon case closure. (The survey
    has a completion rate of 25 percent and is distributed and tabulated
    by MSU); a new, DBS-wide QA/supervision program focusing on quality
    outcomes and best practices, rather than on compliance issues
    exclusively; a discipline-specific self-assessment and training
    acquisition tool for RTs and O&M specialists; and an accessible
    computerized case tracking and management system.

2.  [Peer Support:]{.underline} RTs and O&Ms have established 23 support
    groups in different areas of the state. Additionally, OASIS has
    trained 90 consumer volunteers to provide individualized peer
    support services. Generally, the support groups are started by OASIS
    staff, but are intended to be self-sustaining and led by the members
    themselves. OASIS provides ongoing support to the groups, including
    peer counseling and leadership training, wherever possible. Most of
    the groups are in the northern, more populated areas of the state,
    though efforts are underway to expand the network into the rural
    areas.

3.  [Collaboration]{.underline}: DBS is implementing and further
    developing a comprehensive approach to leverage resources,
    including: a statewide collaborative network involving Area Agencies
    on Aging, Alabama Institute for the Deaf and Blind (AIDB) regional
    offices, senior centers and CILs as part of OASIS' "center-based"
    service provision model; cooperative agreement with AIDB involving
    shared office space, shared RT and O&M specialists and other
    collaboration; underserved populations outreach strategies involving
    CRPs and other community organizations; and close collaboration
    among VR and IL specialists through DSB's "joint service" staffing
    model.

####### OIB Issues Identified by ADRS and Stakeholders During the Review Process

RSA's review process solicited input from ADRS and stakeholders about
OIB performance and compliance issues. The following issues were
identified:

-   rising cost of assistive technology, especially Closed Circuit
    Televisions (CCTVs);

-   rapidly increasing demand for OASIS services due to the demographic
    trends related to the aging population and increasing incidence of
    non-visual, age-related disabilities among older individuals;

-   federal and state funding streams for OASIS have not kept up with
    the increasing demand and assistive technology costs;

-   OASIS is experiencing difficulties in recruiting and retaining RTs
    and O&M specialists; and

-   these factors pose significant service delivery challenges,
    especially with regard to the underserved areas and populations in
    the state.

Following compilation of this list, RSA worked with ADRS to address as
many of these issues as possible either directly or by consolidating the
issue into a broader issue area.

## 

## OIB Performance Issues, Goals, Strategies, and Technical Assistance 

As a result of the review, RSA and ADRS agreed on the following OIB
performance goals, strategies to achieve those goals, and TA that RSA
would provide to assist ADRS achieve each goal.

1\. [Resource development]{.underline}

Issue: ADRS and OIB stakeholders agreed that there is a growing gap
between the demand for OASIS services and the availability of OASIS
resources. OASIS has been able to secure additional funding on an ad hoc
basis, for example, \$35,000 from the state's Assistive Technology Act
program. But OASIS has thus far been unable to secure a stable, ongoing
funding stream other than its current federal and state match funding
sources.

Goal 1: To increase funding beyond the federal allotment.

Strategies:

-   Write a resolution for the Silver Hair Legislature for \$300,000 and
    present it to the Alabama state legislature.

-   Request state funding for an innovative collaborative project in the
    governor's SMART budget.

-   Engage RTs and O&M specialists in concerted efforts to seek local
    opportunities for additional funding and in-kind products and
    services for OASIS consumers.

Goal 2: To leverage resources through increased collaboration.

-   Collaborate with AIDB, VR, SAIL and CILs to expand OASIS'
    center-based service provision model.

-   Develop strategies with VR, SAIL and CILs to provide services to
    unserved/ underserved populations, including the expansion of
    center-based services provision.

-   Implement a cross disability peer support group in collaboration
    with the Birmingham CIL as a pilot project for addressing the needs
    of older individuals with non-visual disabilities.

-   Enhance collaboration between DSB and the CILs through greater
    mutual participation on the statewide OASIS Advisory Council and the
    SILC.

-   Provide more cross training opportunities for OASIS, SAIL and CIL
    staff.

-   Collaborate more closely on the formulation and evaluation of the
    SPIL.

Methods of Evaluation:

-   Present the Silver Hair resolution to the Alabama State Legislature
    by October 2007.

-   Request state funding in the SMART Budget by October 2007.

-   Establish a workgroup of OASIS, SAIL and CIL representatives by
    January 2008 to discuss collaborative initiatives. Present workgroup
    recommendations by October 2008.

[2. OASIS service delivery staff recruitment and retention.]{.underline}

Issue: ADRS' difficulty in recruiting and retaining service delivery
staff is due to the relatively small pool of qualified RT and O&M
candidates from which to draw, as well as the fact that other
institutions such as the Veterans Administration are able to offer
higher salaries.

Goal: To increase the number of qualified RT and O&M candidates on the
state personnel register, and to encourage them to consider joining
ADRS.

Strategies:

-   Develop a recruitment plan to attract rehabilitation teachers and
    orientation and mobility candidates, including assigning a dollar
    amount on benefits package.

-   Utilize the ADRS' paid internship program.

-   Perform a comparative market review on salary schedules for RTs and
    O&M specialists, and proposed any appropriate salary schedule
    revisions to the ADRS human resources department and the state
    personnel department.

-   Develop a recruitment strategy directed at undergraduate programs,
    including a plan to promote the tangible and intangible benefits of
    the RT and O&M careers.

Method of Evaluation:

-   Fifty percent increase in qualified RT and O&M candidates on the
    state personnel register by October 2009.

## Chapter 6: Progress on Issues Raised in Previous Reviews

As a result of the RSA monitoring reviews conducted in FYs 2003 and
2004, ADRS developed a Corrective Action Plan (CAP) to address findings
and recommendations and the corrective action to be taken to ensure
compliance with VR Program requirements. Two findings from these reviews
remained open at the beginning of FY 2007.

###### Corrective Action Plan

Through the implementation of its CAP, ADRS has successfully resolved
all compliance findings related to the following two topics:

1.  Institutions of High Education (IHE) Agreements; and

2.  Closing Records.

[Chapter 7: Summary Conclusion]{.underline}

## Strengths 

-   ADRS takes many more applications, serves many more individuals and
    achieves many more employment outcomes than other general and
    combined agencies taking into account state population and funds
    available.

-   ADRS has developed partnerships with community providers, school
    systems, other government agencies, stakeholders, and employers
    within the State of Alabama.

-   The IL program promotes the IL philosophy and awareness about IL
    issues and services through outreach efforts to all communities in
    Alabama.

-   Through community support, a total of \$527,000 in donated goods and
    services was provided in FY 2006 in support of this program.

-   The OIB program received solicited input from ADRS and stakeholders.
    Promising practices were identified in 3 areas: QA, peer support,
    and collaboration.

## Challenges in the VR and SE programs include:

-   stabilizing overall agency performance expectations;

-   reducing counselor caseload sizes;

-   increasing the rehabilitation rate;

-   further developing AL's SE system, leading to an increase in
    consumers receiving services under this program; and

-   increasing the strategic use of data.

[Challenges in the IL programs include]{.underline}:

-   strengthening the leadership capacity of the SILC;

-   ensuring that SAILS's policies and practices are consistent with IL
    philosophy;

-   obtaining additional resources for IL programs;

-   increasing the number of qualified RT and O&M recruited and
    eventually hired by ADRS; and

-   performance related to VR standards and performance indicators:
    although ADRS has passed standards 1 and 2 since FY 2000, the agency
    has not met indicator 1.5, the average wage rate of their
    competitive closure to the state average wage rate, since FY 2003.

Table 5, beginning on the following page, summarizes the results of
RSA's review.

> **Table 5**
>
> **Summary of the Results of RSA's Review**

+---------------------+----------------------+------------------------+
| **Alabama           |                      |                        |
| Department of       |                      |                        |
| Rehabilitation      |                      |                        |
| Services**          |                      |                        |
+---------------------+----------------------+------------------------+
| **Program: VR**     |                      |                        |
+---------------------+----------------------+------------------------+
| Goal                | Strategies           | Technical Assistance   |
+---------------------+----------------------+------------------------+
| 1\. Stabilize       | -   Study the        | -   RSA staff can      |
| overall agency      |     current          |     assist with the    |
| performance         |     counselor        |     development of     |
| expectations and    |     staffing         |     models to readjust |
| reduce counselor    |     structure with   |     performance        |
| caseload size.      |     respect to       |     expectations and   |
|                     |     caseload size,   |     project how        |
|                     |     employment       |     performance might  |
|                     |     outcome          |     change as staff is |
|                     |     expectations,    |     added.             |
|                     |     and the effects  |                        |
|                     |     of type of       | -   RSA can help       |
|                     |     caseload         |     identify if there  |
|                     |     assignment and   |     are other agencies |
|                     |     location of      |     that have gone     |
|                     |     assignment on    |     through similar    |
|                     |     workload.        |     processes or are   |
|                     |                      |     particularly good  |
|                     | -   Review the       |     at taking into     |
|                     |     current agency   |     account multiple   |
|                     |     staffing pattern |     variables in       |
|                     |     to determine if  |     estimating         |
|                     |     the current      |     performance        |
|                     |     staff            |     outcomes.          |
|                     |     allocations are  |                        |
|                     |     still            |                        |
|                     |     appropriate, and |                        |
|                     |     if not           |                        |
|                     |     appropriate,     |                        |
|                     |     identify         |                        |
|                     |     resources that   |                        |
|                     |     could be         |                        |
|                     |     redirected to    |                        |
|                     |     the field        |                        |
|                     |     program.         |                        |
|                     |                      |                        |
|                     | -   Hire additional  |                        |
|                     |     counselors       |                        |
|                     |     through SMART    |                        |
|                     |     Budget           |                        |
|                     |     appropriations   |                        |
|                     |     requests. (2 VRC |                        |
|                     |     positions were   |                        |
|                     |     requested and    |                        |
|                     |     approved in the  |                        |
|                     |     FY 2008 budget,  |                        |
|                     |     and 10 will be   |                        |
|                     |     requested in the |                        |
|                     |     FY 2009 budget   |                        |
|                     |     request).        |                        |
+---------------------+----------------------+------------------------+
| 2\. Increase the    | -   Review status 28 | -   RSA staff can      |
| rehabilitation rate |     closures to      |     assist with the    |
| from 70 percent to  |     identify reasons |     development of     |
| 74.5 percent by FY  |     for unsuccessful |     information about  |
| 2010.               |     outcomes, and    |     rehabilitation     |
|                     |     continue to      |     rates for groups   |
|                     |     review these     |     that can be        |
|                     |     cases as part of |     identified on the  |
|                     |     QA activities.   |     RSA-911 to         |
|                     |                      |     determine          |
|                     | -   Consider         |     populations found  |
|                     |     requiring one or |     to be at risk in   |
|                     |     more process     |     the national data, |
|                     |     requirements     |     and look at the    |
|                     |     such as          |     national data in   |
|                     |     supervisory      |     other ways that    |
|                     |     review of 28     |     ADRS might find    |
|                     |     cases prior to   |     helpful, as        |
|                     |     closure,         |     needed.            |
|                     |     requiring        |                        |
|                     |     multiple contact | ```{=html}             |
|                     |     numbers at       | <!-- -->               |
|                     |     application to   | ```                    |
|                     |     provide more     | -   RSA can help       |
|                     |     points of        |     identify other     |
|                     |     contact if the   |     agencies that have |
|                     |     individual       |     implemented        |
|                     |     cannot be        |     activities similar |
|                     |     located at the   |     to those being     |
|                     |     primary address, |     considered by ADRS |
|                     |     or establishing  |     to improve the     |
|                     |     minimum          |     rehabilitation     |
|                     |     requirements for |     rate, or, that     |
|                     |     regular personal |     appear to be       |
|                     |     contact. The     |     successful with    |
|                     |     particular type  |     particular groups  |
|                     |     of process       |     of individuals.    |
|                     |     requirement      |                        |
|                     |     should be        |                        |
|                     |     determined by    |                        |
|                     |     the status       |                        |
|                     |     28-closure       |                        |
|                     |     review discussed |                        |
|                     |     above.           |                        |
|                     |                      |                        |
|                     | -   Identify         |                        |
|                     |     population needs |                        |
|                     |     of groups more   |                        |
|                     |     likely to be     |                        |
|                     |     unsuccessful in  |                        |
|                     |     achieving an     |                        |
|                     |     employment       |                        |
|                     |     outcome and      |                        |
|                     |     provide staff    |                        |
|                     |     training and/or  |                        |
|                     |     services to      |                        |
|                     |     address needs.   |                        |
|                     |     Possible         |                        |
|                     |     examples might   |                        |
|                     |     be develop       |                        |
|                     |     training and     |                        |
|                     |     services for     |                        |
|                     |     emerging         |                        |
|                     |     disability       |                        |
|                     |     populations such |                        |
|                     |     as autism,       |                        |
|                     |     culturally       |                        |
|                     |     relevant         |                        |
|                     |     approaches to    |                        |
|                     |     the growing      |                        |
|                     |     Hispanic         |                        |
|                     |     population,      |                        |
|                     |     development of a |                        |
|                     |     focus on serving |                        |
|                     |     older workers    |                        |
|                     |     who do not wish  |                        |
|                     |     to retire but    |                        |
|                     |     are aging into   |                        |
|                     |     disability, etc. |                        |
|                     |                      |                        |
|                     | -   Reduce caseload  |                        |
|                     |     size using       |                        |
|                     |     approach         |                        |
|                     |     outlined under   |                        |
|                     |     the goal of      |                        |
|                     |     reduction of     |                        |
|                     |     caseload size    |                        |
|                     |     and performance  |                        |
|                     |     expectations.    |                        |
+---------------------+----------------------+------------------------+
| 3\. Make efforts to | -   Resolve data     | -   RSA will provide   |
| further develop the |     discrepancies    |     TA upon request.   |
| overall SE system   |     and consistently |                        |
| in AL to provide    |     count and report |                        |
| the foundation for  |     SE outcomes.     |                        |
| increasing the      |                      |                        |
| number of           | -   Meet with senior |                        |
| individuals who     |     management of    |                        |
| appropriately       |     the state        |                        |
| achieve SE          |     developmental    |                        |
| outcomes.           |     disability and   |                        |
|                     |     mental health    |                        |
|                     |     agencies for the |                        |
|                     |     purpose of       |                        |
|                     |     discussing the   |                        |
|                     |     current          |                        |
|                     |     employment       |                        |
|                     |     programs of      |                        |
|                     |     these agencies   |                        |
|                     |     and to determine |                        |
|                     |     how these        |                        |
|                     |     agencies use     |                        |
|                     |     supported        |                        |
|                     |     employment with  |                        |
|                     |     their            |                        |
|                     |     populations,     |                        |
|                     |     including        |                        |
|                     |     identification   |                        |
|                     |     of barriers to   |                        |
|                     |     supported        |                        |
|                     |     employment for   |                        |
|                     |     their            |                        |
|                     |     populations.     |                        |
|                     |                      |                        |
|                     | -   Meet with the    |                        |
|                     |     state Medicaid   |                        |
|                     |     agency to make   |                        |
|                     |     inquiries about  |                        |
|                     |     and/or advocate  |                        |
|                     |     for the          |                        |
|                     |     extension of the |                        |
|                     |     Medicaid waiver  |                        |
|                     |     to groups other  |                        |
|                     |     than those with  |                        |
|                     |     mental           |                        |
|                     |     retardation that |                        |
|                     |     would be likely  |                        |
|                     |     to benefit from  |                        |
|                     |     supported        |                        |
|                     |     employment       |                        |
|                     |     services.        |                        |
+---------------------+----------------------+------------------------+
| 4.  Increase the    | -   Develop report   | -   ADRS will explore  |
|     strategic use   |     templates --     |     local resources    |
|     of data.        |     including        |     for staff          |
|                     |     graphics - for   |     development.       |
|                     |     ADRS program     |                        |
|                     |     reporting.       | -   RSA will provide   |
|                     |                      |     TA in data quality |
|                     | -   Develop report   |     including          |
|                     |     templates --     |     reporting and      |
|                     |     including        |     analytical         |
|                     |     graphics - for   |     techniques to      |
|                     |     ADRS agency      |     support agency     |
|                     |     level reporting. |     operations.        |
|                     |                      |                        |
|                     | -   Develop a        |                        |
|                     |     multi-year plan  |                        |
|                     |     for staff        |                        |
|                     |     development for  |                        |
|                     |     providing ADRS   |                        |
|                     |     staff with       |                        |
|                     |     skills and tools |                        |
|                     |     for analyzing    |                        |
|                     |     and graphically  |                        |
|                     |     presenting data  |                        |
|                     |     to aid           |                        |
|                     |     decision-making  |                        |
|                     |     and to guide     |                        |
|                     |     program          |                        |
|                     |     improvement      |                        |
|                     |     decisions.       |                        |
+---------------------+----------------------+------------------------+
| **ARDS Issues for   |                      |                        |
| Further Review**    |                      |                        |
+---------------------+----------------------+------------------------+
| Possible compliance |                      |                        |
| issue with SE       |                      |                        |
| Milestone CRP       |                      |                        |
| contracts. RSA will |                      |                        |
| be reviewing with   |                      |                        |
| the Department of   |                      |                        |
| Education's Office  |                      |                        |
| of General Counsel  |                      |                        |
| and others the      |                      |                        |
| appropriateness of  |                      |                        |
| meeting the         |                      |                        |
| regulatory          |                      |                        |
| requirements of     |                      |                        |
| identifying a       |                      |                        |
| reasonable          |                      |                        |
| likelihood of the   |                      |                        |
| availability of     |                      |                        |
| extended support    |                      |                        |
| services through a  |                      |                        |
| contract that       |                      |                        |
| requires CRPs to    |                      |                        |
| provide extended    |                      |                        |
| services, possibly  |                      |                        |
| without             |                      |                        |
| reimbursement.      |                      |                        |
+---------------------+----------------------+------------------------+
| **ADRS Promising    |                      |                        |
| Practices**         |                      |                        |
+---------------------+----------------------+------------------------+
| 1.  College         |                      |                        |
|     Preparation     |                      |                        |
|     Programs --     |                      |                        |
|     ADRS operates   |                      |                        |
|     its College     |                      |                        |
|     Preparation     |                      |                        |
|     Programs in 7   |                      |                        |
|     areas of the    |                      |                        |
|     state. Over 400 |                      |                        |
|     students attend |                      |                        |
|     the 2-week      |                      |                        |
|     summer programs |                      |                        |
|     across the      |                      |                        |
|     state.          |                      |                        |
+---------------------+----------------------+------------------------+
| 2.  Career          |                      |                        |
|     Preparation and |                      |                        |
|     Training        |                      |                        |
|     Initiative --   |                      |                        |
|     FY 2006 is the  |                      |                        |
|     fourth year of  |                      |                        |
|     this pilot      |                      |                        |
|     2-week career   |                      |                        |
|     preparation     |                      |                        |
|     training        |                      |                        |
|     program, and a  |                      |                        |
|     partnership     |                      |                        |
|     with local      |                      |                        |
|     school systems, |                      |                        |
|     transportation  |                      |                        |
|     agencies and    |                      |                        |
|     local colleges  |                      |                        |
|     and employers.  |                      |                        |
|     A record number |                      |                        |
|     of 114          |                      |                        |
|     referrals were  |                      |                        |
|     processed for   |                      |                        |
|     FY 2007.        |                      |                        |
+---------------------+----------------------+------------------------+
| 3.  Business        |                      |                        |
|     Relations       |                      |                        |
|     Program - For   |                      |                        |
|     more than 25    |                      |                        |
|     years, ADRS has |                      |                        |
|     formally        |                      |                        |
|     operated a      |                      |                        |
|     business        |                      |                        |
|     relations       |                      |                        |
|     program in      |                      |                        |
|     concert with    |                      |                        |
|     its philosophy  |                      |                        |
|     of "dual        |                      |                        |
|     customer", i.e. |                      |                        |
|     individuals     |                      |                        |
|     with            |                      |                        |
|     disabilities    |                      |                        |
|     and employers.  |                      |                        |
|     Annually the    |                      |                        |
|     ADRS EDC team   |                      |                        |
|     of 17 works     |                      |                        |
|     directly with   |                      |                        |
|     more than 850   |                      |                        |
|     companies       |                      |                        |
|     providing in    |                      |                        |
|     excess of 5,500 |                      |                        |
|     services to     |                      |                        |
|     them statewide. |                      |                        |
+---------------------+----------------------+------------------------+
| 4.  Adaptive        |                      |                        |
|     Driving         |                      |                        |
|     Training        |                      |                        |
|     Program --      |                      |                        |
|     Services        |                      |                        |
|     through this    |                      |                        |
|     program are     |                      |                        |
|     provided        |                      |                        |
|     statewide in    |                      |                        |
|     the consumer\'s |                      |                        |
|     home area.      |                      |                        |
|     Relationships   |                      |                        |
|     with            |                      |                        |
|     manufacturers,  |                      |                        |
|     negotiated      |                      |                        |
|     vendor fees,    |                      |                        |
|     and the         |                      |                        |
|     relationship    |                      |                        |
|     with the        |                      |                        |
|     Alabama         |                      |                        |
|     Department of   |                      |                        |
|     Public Safety   |                      |                        |
|     are             |                      |                        |
|     particularly    |                      |                        |
|     noteworthy.     |                      |                        |
+---------------------+----------------------+------------------------+
| **Program: Part B   |                      |                        |
| IL Program**        |                      |                        |
+---------------------+----------------------+------------------------+
| Goal                | Strategies           | Technical Assistance   |
+---------------------+----------------------+------------------------+
| 1.  To strengthen   | -   The SILC will    | RSA will provide       |
|     the capacity of |     assess its       | training and TA as     |
|     the SILC to     |     training needs   | needed, including      |
|     provide the     |     by using the     | reviewing any draft    |
|     independent     |     self-assessment  | revised SILC by-laws,  |
|     living          |     tool, "What      | policies, procedures   |
|     leadership      |     Every SILC       | and public information |
|     envisioned by   |     Member Should    | materials.             |
|     Title VII of    |     Know," at least  |                        |
|     the             |     once a year.     |                        |
|     Rehabilitation  |                      |                        |
|     Act.            | -   ADRS and the     |                        |
|                     |     SILC will        |                        |
|                     |     provide the SILC |                        |
|                     |     with training on |                        |
|                     |     the IL           |                        |
|                     |     philosophy and   |                        |
|                     |     the law          |                        |
|                     |     regarding        |                        |
|                     |     independent      |                        |
|                     |     living,          |                        |
|                     |     especially for   |                        |
|                     |     newly appointed  |                        |
|                     |     members.         |                        |
|                     |                      |                        |
|                     | -   ADRS and the     |                        |
|                     |     SILC will        |                        |
|                     |     explore ways to  |                        |
|                     |     increase         |                        |
|                     |     attendance at    |                        |
|                     |     SILC quarterly   |                        |
|                     |     meetings.        |                        |
|                     |                      |                        |
|                     | -   The SILC will    |                        |
|                     |     make suggestions |                        |
|                     |     regarding the    |                        |
|                     |     creation of a    |                        |
|                     |     co-chair or      |                        |
|                     |     vice-chair       |                        |
|                     |     position to act  |                        |
|                     |     on behalf of the |                        |
|                     |     chair when       |                        |
|                     |     absences occur.  |                        |
|                     |                      |                        |
|                     | -   The SILC will    |                        |
|                     |     develop and      |                        |
|                     |     implement        |                        |
|                     |     systems for      |                        |
|                     |     tracking         |                        |
|                     |     members' term    |                        |
|                     |     dates and        |                        |
|                     |     appointment      |                        |
|                     |     status and for   |                        |
|                     |     identifying and  |                        |
|                     |     nominating       |                        |
|                     |     prospective SILC |                        |
|                     |     members.         |                        |
|                     |                      |                        |
|                     | -   ADRS and the     |                        |
|                     |     SILC will        |                        |
|                     |     establish a      |                        |
|                     |     mechanism for    |                        |
|                     |     periodically     |                        |
|                     |     assessing the    |                        |
|                     |     SILC's funding   |                        |
|                     |     needs to ensure  |                        |
|                     |     that the SILC    |                        |
|                     |     resource plan    |                        |
|                     |     adequately       |                        |
|                     |     addresses the    |                        |
|                     |     resource needs   |                        |
|                     |     of the SILC for  |                        |
|                     |     the fulfillment  |                        |
|                     |     of its statutory |                        |
|                     |     roles and        |                        |
|                     |                      |                        |
|                     |    responsibilities. |                        |
+---------------------+----------------------+------------------------+
| 2.  To ensure that  | -   Review and       | RSA will provide       |
|     all SAILS'      |     revise SAILS'    | training and TA as     |
|     policies and    |     policies,        | needed, including      |
|     practices are   |     procedures and   | reviewing any draft    |
|     fully           |     practices, as    | policies and           |
|     consistent with |     necessary.       | procedures revisions.  |
|     the IL          |                      |                        |
|     philosophy.     | -   Provide ADRS IL  |                        |
|                     |     specialists with |                        |
|                     |     the              |                        |
|                     |     corresponding    |                        |
|                     |     training, as     |                        |
|                     |     necessary.       |                        |
|                     |                      |                        |
|                     | -   Review and       |                        |
|                     |     enhance SAILS'   |                        |
|                     |     QA system for IL |                        |
|                     |     services.        |                        |
+---------------------+----------------------+------------------------+
| 3.  Obtain or       | -   Provide cross    | RSA will provide the   |
|     leverage        |     training for IL  | Alabama IL partners    |
|     additional      |     Specialists and  | with TA upon request   |
|     resources for   |     Economic         | and may propose        |
|     the Alabama IL  |     Development EDCs | additional             |
|     programs by     |     and work         | collaborative          |
|     maximizing      |     collaboratively  | opportunities in areas |
|     collaborative   |     with the EDCs    | such as pre-vocational |
|     efforts among   |     and job coaches  | skills training,       |
|     all ADRS        |     to identify      | assistive technology   |
|     divisions.      |     consumers who    | and transition from    |
|                     |     would benefit    | institutions.          |
|                     |     from IL          |                        |
|                     |     available        |                        |
|                     |     services in      |                        |
|                     |     support of their |                        |
|                     |     employment       |                        |
|                     |     goals.           |                        |
|                     |                      |                        |
|                     | -   Develop          |                        |
|                     |     strategies with  |                        |
|                     |     VR, OASIS, EI    |                        |
|                     |     and CRS staff to |                        |
|                     |     provide services |                        |
|                     |     to unserved and  |                        |
|                     |     underserved      |                        |
|                     |     populations.     |                        |
|                     |                      |                        |
|                     | -   Provide          |                        |
|                     |     education to VR  |                        |
|                     |     counselors, EI   |                        |
|                     |     staff, and CRS   |                        |
|                     |     staff at the     |                        |
|                     |     local levels to  |                        |
|                     |     increase         |                        |
|                     |     knowledge of IL  |                        |
|                     |     services         |                        |
|                     |     available        |                        |
|                     |     through the SAIL |                        |
|                     |     program.         |                        |
|                     |                      |                        |
|                     | -   Promote          |                        |
|                     |     collaboration on |                        |
|                     |     youth transition |                        |
|                     |     by continuing to |                        |
|                     |     attend Teen      |                        |
|                     |     Transition       |                        |
|                     |     Clinics          |                        |
|                     |     routinely at all |                        |
|                     |     locations        |                        |
|                     |     throughout the   |                        |
|                     |     state and by     |                        |
|                     |     establishing     |                        |
|                     |     contacts at      |                        |
|                     |     local education  |                        |
|                     |     agencies that    |                        |
|                     |     will allow for   |                        |
|                     |     provision of IL  |                        |
|                     |     services to      |                        |
|                     |     students in      |                        |
|                     |     transition.      |                        |
|                     |                      |                        |
|                     | -   Explore the      |                        |
|                     |     possibility of   |                        |
|                     |     developing and   |                        |
|                     |     presenting any   |                        |
|                     |     of these joint   |                        |
|                     |     strategies or    |                        |
|                     |     activities as an |                        |
|                     |     innovative pilot |                        |
|                     |     project for      |                        |
|                     |     possible funding |                        |
|                     |     through the      |                        |
|                     |     SMART budget     |                        |
|                     |     process.         |                        |
|                     |                      |                        |
|                     | -   Involve the CILs |                        |
|                     |     in the           |                        |
|                     |     applicable       |                        |
|                     |     strategies and   |                        |
|                     |     activities       |                        |
|                     |     discussed above, |                        |
|                     |     as appropriate.  |                        |
|                     |                      |                        |
|                     | -   Provide SAIL,    |                        |
|                     |     OASIS and CIL    |                        |
|                     |     staff cross      |                        |
|                     |     training for     |                        |
|                     |     implementing the |                        |
|                     |     joint strategies |                        |
|                     |     and activities.  |                        |
|                     |                      |                        |
|                     | Method of            |                        |
|                     | Evaluation:          |                        |
|                     |                      |                        |
|                     | -   A workgroup      |                        |
|                     |     consisting of    |                        |
|                     |     representatives  |                        |
|                     |     from SAILS,      |                        |
|                     |     OASIS, CILs, the |                        |
|                     |     SILC and other   |                        |
|                     |     ADRS divisions   |                        |
|                     |     will present its |                        |
|                     |     recommendations  |                        |
|                     |     for new          |                        |
|                     |     collaborative    |                        |
|                     |     initiatives,     |                        |
|                     |     including a      |                        |
|                     |     possible SMART   |                        |
|                     |     budget pilot     |                        |
|                     |     project          |                        |
|                     |     proposal, by     |                        |
|                     |     June 30, 2008.   |                        |
+---------------------+----------------------+------------------------+
| **IL Promising      |                      |                        |
| Practices**         |                      |                        |
+---------------------+----------------------+------------------------+
| ADRS' seven         |                      |                        |
| independent living  |                      |                        |
| specialists are     |                      |                        |
| able to cover the   |                      |                        |
| whole state of      |                      |                        |
| Alabama, including  |                      |                        |
| large rural areas,  |                      |                        |
| through an          |                      |                        |
| entrepreneurial     |                      |                        |
| service provision   |                      |                        |
| approach.           |                      |                        |
+---------------------+----------------------+------------------------+
| **Program: OIB**    |                      |                        |
+---------------------+----------------------+------------------------+
| Goal                | Strategies           | Technical Assistance   |
+---------------------+----------------------+------------------------+
| 1.  To increase     | -   Write a          | > RSA will provide TA  |
|     funding beyond  |     resolution for   | > upon request.        |
|     the federal     |     the Silver Hair  |                        |
|     allotment.      |     Legislature for  |                        |
|                     |     \$300,000 and    |                        |
|                     |     present it to    |                        |
|                     |     the Alabama      |                        |
|                     |     state            |                        |
|                     |     legislature.     |                        |
|                     |                      |                        |
|                     | -   Request state    |                        |
|                     |     funding for an   |                        |
|                     |     innovative,      |                        |
|                     |     collaborative    |                        |
|                     |     project in the   |                        |
|                     |     governor's SMART |                        |
|                     |     budget.          |                        |
|                     |                      |                        |
|                     | -   Engage RTs and   |                        |
|                     |     O&M specialists  |                        |
|                     |     in concerted     |                        |
|                     |     efforts to seek  |                        |
|                     |     local            |                        |
|                     |     opportunities    |                        |
|                     |     for additional   |                        |
|                     |     funding and      |                        |
|                     |     in-kind products |                        |
|                     |     and services for |                        |
|                     |     OASIS consumers. |                        |
+---------------------+----------------------+------------------------+
| 2.  To leverage     | -   Collaborate with | > RSA will provide TA  |
|     resources       |     AIDB, VR, SAIL   | > upon request.        |
|     through         |     and CILs to      |                        |
|     increased       |     expand OASIS'    |                        |
|     collaboration.  |     center-based     |                        |
|                     |     service          |                        |
|                     |     provision model. |                        |
|                     |                      |                        |
|                     | -   Develop          |                        |
|                     |     strategies with  |                        |
|                     |     VR, SAIL and     |                        |
|                     |     CILs to provide  |                        |
|                     |     services to      |                        |
|                     |     unserved/        |                        |
|                     |     underserved      |                        |
|                     |     populations,     |                        |
|                     |     including the    |                        |
|                     |     expansion of     |                        |
|                     |     center-based     |                        |
|                     |     services         |                        |
|                     |     provision.       |                        |
|                     |                      |                        |
|                     | -   Implement a      |                        |
|                     |     cross disability |                        |
|                     |     peer support     |                        |
|                     |     group in         |                        |
|                     |     collaboration    |                        |
|                     |     with the         |                        |
|                     |     Birmingham CIL   |                        |
|                     |     as a pilot       |                        |
|                     |     project for      |                        |
|                     |     addressing the   |                        |
|                     |     needs of older   |                        |
|                     |     individuals with |                        |
|                     |     non-visual       |                        |
|                     |     disabilities.    |                        |
|                     |                      |                        |
|                     | -   Enhance          |                        |
|                     |     collaboration    |                        |
|                     |     between DSB and  |                        |
|                     |     the CILs through |                        |
|                     |     greater mutual   |                        |
|                     |     participation on |                        |
|                     |     the statewide    |                        |
|                     |     OASIS Advisory   |                        |
|                     |     Council and the  |                        |
|                     |     SILC.            |                        |
|                     |                      |                        |
|                     | -   Provide more     |                        |
|                     |     cross training   |                        |
|                     |     opportunities    |                        |
|                     |     for OASIS, SAIL  |                        |
|                     |     and CIL staff.   |                        |
|                     |                      |                        |
|                     | -   Collaborate more |                        |
|                     |     closely on the   |                        |
|                     |     formulation and  |                        |
|                     |     evaluation of    |                        |
|                     |     the SPIL.        |                        |
+---------------------+----------------------+------------------------+
| 3.  To increase the | -   Develop a        | > RSA will provide TA  |
|     number of       |     recruitment plan | > upon request.        |
|     qualified RT    |     to attract       |                        |
|     and O&M         |     rehabilitation   |                        |
|     candidates on   |     teachers and     |                        |
|     the state       |     orientation and  |                        |
|     personnel       |     mobility         |                        |
|     register, and   |     candidates,      |                        |
|     to encourage    |     including        |                        |
|     them to         |     assigning a      |                        |
|     consider        |     dollar amount on |                        |
|     joining ADRS.   |     benefits         |                        |
|                     |     package.         |                        |
|                     |                      |                        |
|                     | -   Utilize the ADRS |                        |
|                     |     paid internship  |                        |
|                     |     program.         |                        |
|                     |                      |                        |
|                     | -   Perform a        |                        |
|                     |     comparative      |                        |
|                     |     market review on |                        |
|                     |     salary schedules |                        |
|                     |     for RTs and O&M  |                        |
|                     |     specialists, and |                        |
|                     |     proposed any     |                        |
|                     |     appropriate      |                        |
|                     |     salary schedule  |                        |
|                     |     revisions to the |                        |
|                     |     ADRS human       |                        |
|                     |     resources        |                        |
|                     |     department and   |                        |
|                     |     the state        |                        |
|                     |     personnel        |                        |
|                     |     department.      |                        |
|                     |                      |                        |
|                     | -   Develop a        |                        |
|                     |     recruitment      |                        |
|                     |     strategy         |                        |
|                     |     directed at      |                        |
|                     |     undergraduate    |                        |
|                     |     programs,        |                        |
|                     |     including a plan |                        |
|                     |     to promote the   |                        |
|                     |     tangible and     |                        |
|                     |     intangible       |                        |
|                     |     benefits of the  |                        |
|                     |     RT and O&M       |                        |
|                     |     careers.         |                        |
+---------------------+----------------------+------------------------+
| **OIB Promising     |                      |                        |
| Practices**         |                      |                        |
+---------------------+----------------------+------------------------+
| 1.  Quality         |                      |                        |
|     Assurance:      |                      |                        |
|     OASIS monitors, |                      |                        |
|     evaluates and   |                      |                        |
|     ensures quality |                      |                        |
|     OIB services    |                      |                        |
|     and outcomes    |                      |                        |
|     through a       |                      |                        |
|     variety of      |                      |                        |
|     integrated      |                      |                        |
|     approaches and  |                      |                        |
|     tools.          |                      |                        |
+---------------------+----------------------+------------------------+
| 2.  Peer Support:   |                      |                        |
|     RTs and O&Ms    |                      |                        |
|     have            |                      |                        |
|     established 23  |                      |                        |
|     support groups  |                      |                        |
|     in different    |                      |                        |
|     areas of the    |                      |                        |
|     state.          |                      |                        |
+---------------------+----------------------+------------------------+
| 3.  Collaboration:  |                      |                        |
|     DBS is          |                      |                        |
|     implementing    |                      |                        |
|     and further     |                      |                        |
|     developing a    |                      |                        |
|     comprehensive   |                      |                        |
|     approach to     |                      |                        |
|     leverage        |                      |                        |
|     resources,      |                      |                        |
|     including a     |                      |                        |
|     statewide       |                      |                        |
|     collaborative   |                      |                        |
|     network.        |                      |                        |
+---------------------+----------------------+------------------------+

Please take a moment to participate in a survey about RSA\'s performance
on the FY 2007 monitoring of Vocational Rehabilitation agencies.

Visit
<http://www.ed.gov/rschstat/eval/rehab/107-reports/2007/index.html>

[^1]:
    > ^1^ RSA notes the potential conflict between Goal 1 and Goal 2,
    > i.e., Goal 1 is premised on the observation that the current high
    > performance targets are straining the service system, and Goal 2
    > raises a performance target for the rehabilitation rate. While
    > Goal 2's intent is laudatory, RSA advises ADRS that if Goal 1 in
    > not accomplished, pursuing Goal 2 may further strain the service
    > system. Conversely, accomplishing Goal 1 is likely to increase the
    > likelihood of achieving the Goal 2 targets.