OMB No. 1820-0520

Expires:

 

STATE ASSURANCES

CLIENT ASSISTANCE PROGRAM GRANTS

SECTION 112 OF THE REHABILITATION ACT OF 1973, AS AMENDED

1. _____________________________________________________________

 (Name of Agency)

has been designated to operate the Client Assistance Program (CAP) under 

Section 112 of the Rehabilitation Act of 1973, as amended (Act).

2. The governor will not redesignate the above-named agency without good cause 

and only in compliance with provisions of Section 112(c)(1)(B) of the Act and the 

implementing regulations.

3. The designated agency is independent of any agency that provides treatment, 

services, or rehabilitation to individuals under the Rehabilitation Act; or the state 

is exempt from the independence requirement under Section 112(c)(1)(A) of the 

Act and the implementing regulations.

4. The designated agency has the authority to pursue legal, administrative and 

other appropriate remedies to ensure the protection of the rights of individuals 

with disabilities in the state who are seeking or receiving treatment, services, or 

rehabilitation under the Act.

5. The authority to pursue remedies described in paragraph four (4) includes the 

authority to pursue those remedies against the state vocational rehabilitation 

agency and other appropriate state agencies. The designated agency meets this 

requirement if it has the authority to pursue these remedies either on its own 

behalf or by obtaining necessary services, such as legal representation, from 

outside sources.

6. The state will ensure that all entities conducting, administering, operating, or 

carrying out programs within the Section will advise all individuals seeking or 

receiving services under the Act of the existence of the CAP, the services 

provided by the CAP, and how to contact the CAP.

7. The designated agency will submit to the secretary an annual report on the 

operation of the CAP during the previous year consistent with 34 CFR 370.44, 

including a summary of the work done and the uniform tabulation of all cases 

handled by the CAP in the format prescribed by RSA.
Page 2 – OMB Form –1820-0520

8. Pursuant to Section 21 of the Act, the designated agency will address the needs 

of individuals with disabilities from minority backgrounds in the manner set forth 

in the state's application for CAP assistance.

9. A state must provide to the Secretary, as part of its application for assistance, an 

assurance that direct payment to the designated agency is not prohibited by or 

inconsistent with state law, regulation, or policy.

10. The designated agency will meet each of the requirements set forth in Section 

112 of the Act and 34 CFR Part 370.

_________________________________ Date ___________

 (Signature of Governor) 

Public Burden Statement:

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of 

information unless such collection displays a valid OMB control number. Public reporting burden for this 

collection of information is estimated to average 10 minutes per response, including time for reviewing 

instructions, searching existing data sources, gathering and maintaining the data needed, and completing 

and reviewing the collection of information. The obligation to respond to this collection is required to 

obtain or retain benefit (Rehabilitation Act of 1973, as amended). Send comments regarding the burden 

estimate or any other aspect of this collection of information, including suggestions for reducing this 

burden, to the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20210-4537 or 

email ICDocketMgr@ed.gov and reference the OMB Control Number 1820-0520. Note: Please do not 

return the completed CAP Assurances form to this address.