# Presentation: 565894

## Disability Program Challenges: Myth vs. Reality

- Job Corps Leadership Equal Opportunity Workshop
- April 6, 2005
- San Francisco, California

## True or False?

- Accommodations water down Job Corps courses or program requirements
- Accommodations are special treatment and give a student with a disability an unfair advantage over another student
- In 2002 average accommodation cost per Job Corps student was $250
- Accommodations allow for unsafe youth to be in Job Corps
- It is easier to accept all applicants than to implement disability accommodation process

**Notes:**
Seek normalcy, common experiences 
If you have ever been up all night drinking coffee and studying for a test and you find the next day you cannot think very clearly .... you are experiencing what it may be like to have a cognitive impairment. 
Has something ever happened at work that upset you so much you could not stop thinking about it-you even went to the movies but could not enjoy the movie. Then you know what it may be like to have an idea intruding in your normal comfortable routine. Even though these experiences differ perhaps radically by the degrees they are felt they nonetheless are commonly understood experiences.
Accommodations aren’t “special treatment”
Accommodations are used only when someone has a functional limitation—the limitation of skills and abilities due to a disability—preventing them from performing essential duties of their job. Be open about the policy of accommodation at your workplace; accommodations—especially those for mental health problems—usually are easy to implement, inexpensive (most cost less than $500, and many have no cost at all), may be temporary (when someone is adjusting after their return to work, for example) 

## True or False?

- In order for the disability accommodation process to be fully implemented, the regional office, contractors, outreach and admissions (OA), and center directors must understand and support the process
- There are youth with severe depression or youth with a history of drugs and alcoholism who are judged not on the basis of their abilities, but rather upon stereotypes and fears that center staff may associate with their conditions
- Accommodation philosophy–Say NO when we can and YES only when we have to

**Notes:**
Seek normalcy, common experiences 
If you have ever been up all night drinking coffee and studying for a test and you find the next day you cannot think very clearly .... you are experiencing what it may be like to have a cognitive impairment. 
Has something ever happened at work that upset you so much you could not stop thinking about it-you even went to the movies but could not enjoy the movie. Then you know what it may be like to have an idea intruding in your normal comfortable routine. Even though these experiences differ perhaps radically by the degrees they are felt they nonetheless are commonly understood experiences.
Accommodations aren’t “special treatment”
Accommodations are used only when someone has a functional limitation—the limitation of skills and abilities due to a disability—preventing them from performing essential duties of their job. Be open about the policy of accommodation at your workplace; accommodations—especially those for mental health problems—usually are easy to implement, inexpensive (most cost less than $500, and many have no cost at all), may be temporary (when someone is adjusting after their return to work, for example) 

## Challenges of Disability Program

- Applicants which may cause concern
- Drug and alcohol abuse history
- Low IQ – Mental retardation
- Learning disabilities
- Learning difficulty vs. learning disability
- Chronic psychiatric history
- Multiple hospitalizations
- Recent hospital discharge
- History of suicide attempts
- Non-compliance with medication

**Notes:**
***Let participants add challenges, make interactive discussion

Have Valerie talk about some of things going on to address issues.

Develop behavioral descriptors for students that can be shared with center staff ( residential living staff)

Suitability Section of the ACAT

Data Collection—Disability, long term placement

## Focus Areas

- Case management focus
- Staff involvement
- Psychotropic medication
- Other issues

**Notes:**
During assessments for regional staff
For center directors things that should be happening on center

## Recommendations for Denial and Separations

**Reasonable accommodation (PRH)**
- Denials only for
- Undue hardship
- Fundamental alteration
- Center must take any action that would not result in hardship or alteration but would permit applicant to participate in program
- Cannot deny admission solely on need to provide reasonable accommodation
**Disability (PRH)**
- Cannot be denied for safety reasons unless his/her disability is determined to pose a “direct threat” to the health or safety of others or the student
- MUST INCLUDE CURRENT ASSESSMENT OF STABILITY, SAFETY, AND/OR RISK
- NO DENIALS BASED SOLELY ON DIAGNOSIS, HISTORY, FEELINGS, BELIEFS, OR STEREOTYPES

**Notes:**
LD
LD TAG & Web TAG (soon)
Try to partner w/ school system, charter school, as instructors are replaced look for candidates w/ LD or sp ed background

Denials/Separations, Discuss these points
Civil rights lawsuits
Process can be more important than disposition
Is it easier to accept applicants rather than implement disability process?
Liability

## Scenarios

- Two types of  scenarios
- Admission
- Separation
- Questions to consider
- Would you recommend acceptance or denial for this applicant? Why?
- What types of accommodations might be helpful for this applicant or could have been explored?
- Are there any possible civil rights issues?

##  Scenario

- Brittany Spears, age 19, is requesting admission to Job Corps, she provides the following information to the admissions counselor (AC):
- History of depression, currently in treatment with a community psychologist
- Hospitalized 3 months ago for suicidal behavior
- Letter from the psychologist stating that she is stable to join Job Corps, but needs to continue medications and therapy
- Not requesting any accommodations
**Center Process:**
- The center IDT received the applicant’s file and due to the mental health history the CMHC reviewed the file.  The CMHC recommended a denial due to the recent hospitalization and the need for continued therapy
- The file was forwarded to the Regional Office
**Regional Process:**
- RMHC reviewed the file and indicated that admission should be delayed until therapy could be completed
- Applicant’s admission to Job Corps was disapproved until treatment could be completed
- Notification given to applicant by AC

## Scenario

- You have just determined that Jane Doe, 28, a wheelchair user, is eligible for Job Corps (she requested a waiver of the upper age limit because of a disability) and selected the center nearest to her home for assignment.  As you complete the ETA 6-53, she informs you that she:
- Is paralyzed from the waist down
- Takes insulin and is worried about how she will store it on center
- Gets disability checks
- Goes to county clinic
- Wants to live in the dorms
- What would the AC do next?

**Notes:**
Release of Information for the applicant=s physician(s) to provide health records and provides documentation to support disability claim for waiver of upper age limit). , goal is continuity of care
*  Packet includes Admission Counselor Health Question hints, a guide to getting appropriate documentation for particular conditions
 Discuss and document (reasonable accommodation form) need for reasonable accommodation
Diabetic equipment storage
Example of request:
I need a small refrigerator to store my insulin and a locked drawer for my diabetic equipment.
Any needs related to paralysis?
Bottom bunk, bottom floor, personal care needs
 Suggest tour of center to deal w/ accessibility concerns/issues
Ask about past reasonable accommodations (what, when, where)
 Ask about past involvement with vocational rehabilitation or other service provider 
 Investigate who determined the applicant=s eligibility for SSDI.
Provides information about professional who made an assessment of this applicant=s disability and determined her eligibility for SSDI.  The AC will obtain the Release of Information and forward to this provider/agency.
 Also discuss with SSI if/how participation in and employment after JC will affect benefits 

## Scenario

- Michael Jackson, age 20, is requesting admission to Job Corps,
- 	he provides the following information to the AC:
- Diagnosed with schizophrenia and over the past year has been stable and able to manage his own medications
- Recent evaluation from therapist to support entry to Job Corps.  Evaluation indicates that Michael will need to remain on medication, consider low stress trade, and have access to mental health support
- Michael was an A/B student in high school and actually took some advanced courses
**Center Process:**
- The center IDT received the applicant’s file and due to the mental health history arranged for the applicant to meet CMHC for a face to face interview
- CMHCs evaluation indicated that while the applicant was not actively psychotic, he did not feel the applicant could function in Job Corps due to his severe diagnosis, the negative symptoms associated with the diagnosis (flat affect and mood), and the risk for future decompensation
- The file was forwarded to the Regional Office
**Regional Process:**
-  **What happens now—accept or deny?**

##  Scenario

- Janet Mars, age 28, is requesting an age waiver to participate in a Job Corps program in Kentucky stating that she has a disability.  Janet is a resident of Maryland.  The age waiver was granted conditionally in CIS by the regional office.
- Janet provides the following information to the AC:
- Methadone maintenance for prior drug use
- Physician letter stating that she is progressing and her methadone dosage has decreased during the past year
- Requesting clerical trade
- Applicant's mother will obtain the methadone from the physician and mail it to the center each month

**Notes:**
Center Process:
1.      The Kentucky center called the MD to discuss Jane’s present status on Methadone.  The physician told them that Methadone could not be mailed across state lines.
2.      The Kentucky center notified the regional nurse consultant who discussed the issue with the regional office.
3.      The decision was to submit Jane’s folder to a center closer to home
4.      The new center called together an IDT consisting of the MD, CDD, CMHC, Clerical trade instructor, and TEAP. 
5.      The MD was contacted and stated that Jane was doing well and continued to decrease her use of Methadone.  He did not feel that Jane was using Methadone as a substitute drug but as a tool to get clean.  She could be seen every three months in his clinic and he could continue to provide her medication.
6.      The center physician stated that Jane could work in the clerical trade without concern for safety while using Methadone.
7.      The CMHC and TEAP specialist were willing to meet with this student to provide support.
8.      When the student was called she stated that she was still interested in the program and was willing to accept the center’s control of her medication.
9.      The center accepted the applicant with accommodation in the medical area consisting of medicine monitoring and TEAP/CMHC support. 

Student Progress:
1.      After 6 months the student is progressing in her trade
2.      The student continues to decrease her use of Methadone

##  Scenario

- Jennifer Lopez, age 20, arrived on center with a file that indicated she had no health problems.  After arrival Jennifer told the wellness staff that she had a state certificate that allowed her to use medical marijuana.  She used the marijuana on weekends to eliminate the nausea caused by a psychotropic medication she took daily.
- What are the next steps for the center?

**Notes:**
Center Disability/Medical Process
1.      Information was requested regarding the psychotropic medication and the mental health consultant contacted the student’s provider for more information.
2.      The student was told that the federal government did not recognize the use of medical marijuana and it could not be used on federal property or while in a federally funded program.
3.      The student was told that she must comply with all ZT regulations and if she had two positive drug test she would be separated from the program.
4.      The student was given the choice to continue in the program without the use of medical marijuana

Student Decision
1.      The student elected to remain in the program without the use of medical marijuana.
2.      The student was provided with support by the wellness center, the TEAP specialist and the Center Mental Health Consultant.

## Scenario

- John,17, applied to Job Corps in February.  He tells the AC that he was in special classes in school and thinks he can be successful in Job Corps with some extra help in the classroom and with reading.
**Admissions Counselor Process**
- 	The AC contacted the school system to obtain an IEP and transcript  	and forwarded this information with the file to the center.
**Center Process**
- 	The center reviewed the IEP and transcript, and then requested 	further information from the student’s school and school psychologist.
- 	The information was received and indicated that extra instructional 	time and reading material to the applicant had been provided in the 	past.
- 	The center did not accept the application and in July sent it to the 	region for final determination.
**What should the region do?**

**Notes:**
o       What did the region do?
The region sent the application to the regional mental health consultant (RMHC) for his input.
2.      The RMHC recommended the approval of the applicant.
3.      The region conducted a behavior review and approved the applicant for admission
.	The file was returned to the center and the center was directed to accept the applicant and provide a date for entry as soon as possible. 

Application processing time probably not reasonable for this situation

o       No OA or center log with documentation to track application process (when applicant applied to program, when file was sent to center, where file is located on center).

o       AC did not document verbal request for accommodation on request form. 

o       The center did not engage the applicant in an interactive process to determine the applicant’s accommodation needs or offer alternate accommodations, made decision about what accommodations were needed and center’s ability to provide the accommodations based on records
	At the center level, applicant denied admission to the program based solely on need for reasonable accommodation 

## Scenario

- Student John Travolta has been on the center doing well for 9 months
- Previous diagnosis of organic brain disorder (which may lead to outbursts)
- Began having mild seizures and was taken out of his trade until seizures could be controlled, he was not happy, felt staff were taking too long to get him back into trade, became belligerent with staff and in meeting with center director became verbally aggressive and knocked over a chair.
- Due to previous psychiatric history referred to the CMHC for evaluation, diagnosed as “intermittent explosive disorder”, medical separation recommended
- Sued Job Corps for wrongful separation due to disability

## Scenario

- George Bush, age 56, requested an age waiver, due to a disability, to participate in Job Corps, the waiver was conditionally granted by the regional office
- Stated that his disability was based on an injury and provided medical documentation that was two years old and a statement indicating social security disability payment
**Center Process:**
- Disability coordinator requested that the applicant provide current information regarding his disability
- During the telephone contact the applicant stated a wish to live on the center in a trailer and was informed that this was not possible
- The applicant sent a medical statement from a physician that did not indicate any evidence of disability
- A social security statement listed the disability status as being temporary three years ago
- The applicant provided no further updated information

**Notes:**
Due to the lack of information regarding current disability the center   recommended the applicant’s age waiver be rescinded and the application denied.  The regional office agreed.

## What Can Leadership Do?

**Center**
- Support the disability coordinator and EO officer in developing a center-wide culture of inclusion (and reinforce through continuous training)
- Develop center policy for file review process
- Require center log to monitor file processing time/activities (e.g., date file is logged on center and location of file on center)
- Have health and wellness manager or designee review all applicant files, if possible
- Require appropriate staff to contact all students with health/disability issues before arrival
- When possible, require that accommodations be in place before student arrives on center

## What Can Leadership Do?

**Region**
- Develop regional tracking/audit system to monitor center file processing time
- Develop regional policy for file review process or review/approve center policies
- Monitor centers/contractors for compliance and implementation of EO-related activities (e.g., center disability program, OA practices)

## What Can Leadership Do?

**OA**
- Require center and OA logs to monitor file processing time/activities (e.g., date process begins/entry into OASIS, date file is sent to center, date file is logged on center, number of days file takes to process on center, location of file on center)
- Ensure all applicants receive and understand EO information, including reasonable accommodation request form
- Work with center staff to obtain appropriate information before file is sent to center
- Encourage applicants to share health/disability during the admissions process
- Promising practices to share?

**Notes:**
Promising practices-What have participants done to meet some of the challenges discussed during presentation? To encourage discussion-Can give disability website tote bags (2-3) to those who share best ideas.

## Technical Resources

- Job Corps Disability Website
- Disability Coordinator Orientation
- Video: Team Approach to Accommodating Students with Disabilities in Job Corps
- Promising Practices
- Training materials on various topics
- Links to outside resources

**Notes:**
Center disability program model has all requirements from PRH and information and materials on how to accomplish each requirement

## Staff Resources

- Regional Health Consultants
- Humanitas, Michelle Day_[michelle.day@humanitas.com](mailto:michelle.day@humanitas.com)__ __301-608-3290 ext 205_
- National Office, Barbara Grove_[grove.barbara@dol.gov](mailto:grove.barbara@dol.gov)__ __202-693-3116_