HISTORY CHRONOLOGY OF ARIZONA ADMINISTRATIVE REORGANIZATION AND SRS GRANTS The relationship of the VR unit within the Arizona Department of Economic Security and the several SRS grants in question, while parallel in occurrence, has little real cause-effect substance. On January 1, 1972, the Arizona State Legislature was awarded the first Federal grant to be given a Legislature to employ a professional staff to meet the basic needs of the Legislature for quality technical assistance in general human services. The State proposal was preceded by approximately 6 years' research activity by the University of Arizona Rehabilitation Center which closely examined the role and functions of human resource specialists. The January 1, 1972 grant thus represented the fruition of a lengthy undertaking involving joint Federal-State-legislative and university efforts. The project is therefore the result of significant team efforts. This grant was not specifically related to the development of the Arizona reorganization plan. In fact, the report of a Governor's task force recommending reorganization was presented in February 1970. In February 1971, a Senate Bill legislating reorganization was introduced but failed to pass during that legislative session. A reorganization bill, Senate Bill 1068, was reintroduced the next year and passed in May 1972. Reorganization efforts were therefore well underway before the grant was awarded in January 1972. Given the usual start-up time of several months before a grant becomes operational, the reorganization plan was legislated before the project was really active. It should be recognized that the action of a legislature while it may be based upon research findings and scholarly reports is, in the last analysis, an interpretation of those findings and reports; in that light the responsibility for the actions taken are not that of the researchers or the grantees. The Services Integration Grant was submitted May 4, 1973. It was cleared by the Arizona State A-95 Clearinghouse on May 7, 1973. The proposal was thoroughly reviewed by the Regional Directors' Office, by the Rehabilitation Services Administration, and finally by an HEW Interagency Task Force. It was clearly recognized that a waiver would be necessary to effect the objectives of the project. It was the understanding of the Task Force that a waiver would be requested. This, unfortunately, has not been done by the State of Arizona. Our recourse at this point will be to withdraw the SRS R&D portion of the funds granted to the services integration project. The objectives of this grant are well in line with the general purposes of the services integration program in that "one stop" service centers are proposed to meet the multiple needs of people. The purpose of the services integration program in general is to find ways to provide clients with needed services through a rational system which is comprehensive, continuous, effective, and efficient; a system that is coordinated with respect to the 270 odd programs within HEW. ANALYSIS ARIZONA DEPARTMENT OF ECONOMIC SECURITY, Re Information memorandum. Chief, Rehabilitation Services Bureau The Rehabilitation Services Bureau is the watchdog of the Department for integrity and quality of vocational rehabilitation services to handicapped persons in Arizona. Sound management practice dictates that quality control be performed by persons other than those who are actually providing direct services to clients. The Bureau's objectives include: Program evaluation, objective measurement of results, assurance of compliance with accepted administrative practice, upholding the integrity of the vocational rehabilitation program and process, as well as State and Federal regulations, and other necessary activities which contribute to a well-integrated, efficient economical and resourceful service delivery system. The Bureau staff analyzes and digests all information pertinent to the operation of vocational rehabilitation programs in Arizona. They also coordinate closely with other organizational components of the Department in identifying the H183 74 unique needs of the handicapped in Arizona. The Bureau relates all data to implementation of operational procedures for Arizona's vocational_rehabilitation program. In so doing, the Bureau provides the Director of the Department with program parameters in view of the needs, federal laws, regulations, program letters, guidelines, and state legislation relating to the vocational rehabilitation program. The knowledge, experience and expertise of the highly qualified staff is not, then devoted to the day-to-day supervision of direct service personnel; rather it is focused on directing and assuring the Department's long range planning, development, and implementation of vocational rehabilitation services within a compatible network of other resources and program components. In performance of its quality control function, the Rehabilitation Services Bureau makes recommendations to the Director which exert a strong, positive influence on delivery of services to the handicapped. The Bureau maintains a continuing monitoring and evaluation of the Field Services Division's delivery of vocational rehabilitation services, and works closely on a consultative basis with District Managers, District Vocational Rehabilitation Consultants, Area Managers, VR Unit Supervisors and Counselors in the resolution of problems and implementation of new programs and program changes. Where immediate problems on program deficiencies are identified during field evaluations by Bureau staff, the issues are discussed directly with the Department personnel involved. In most instances a solution is agreed upon at the time of the visit. Reports of every field evaluation are prepared with Bureau recommendations for strengthening or improving the VR service delivery in the District. District Managers then have ten working days to respond to the recommendations and take corrective action, if such action is indicated. The Director of the Department reviews each report, the action taken, and orders immediate corrective action when necessary. Attachment #11 contains some examples of these field evaluation reports. Out of these evaluations also comes recommendations from the Bureau for new or additional policies and procedures, program and funding priorities, and staff training. Bureau staff also coordinate these recommendations and their implementation with the Department's staff components for budget, accounting, data processing, research and statistics, personnel, and resource planning. Training for VR service delivery personnel is conducted with Bureau staff serving as instructors, or coordinators of the training. Experienced VR personnel in the Bureau perform its mission and functions. Current projections call for a manning table of 169 positions in the very near future. In approving these positions, the Department has not only strengthened the quality of vocational rehabilitation services in Arizona, but has given long overdue recognition of the need for greater effectiveness and accountability of these services. Program results since the reorganization strongly indicate that VR services have been strengthened by integration within DES. The VR program had 195 "26" closures (persons rehabilitated) for the period of July-October, 1972. During the same period for this year there had already been 317 "26" closures accounted for, an unparalleled increase of 62.6% while some agencies "cream" to achieve results of this magnitude, a breakdown of these "26" closures by disabling category substantiates that a large number of rehabilitations are occurring with the more severely disabled. See Attachment #10. Analysis of the figures points out that the deaf, amputees and orthopedically handicapped, mentally ill and mentally retarded are well represented. The presence of other difficult to rehabilitate persons with character, personality and behavioral disorders, as well as alcoholism and drug abuse problems, also clearly obviate any conclusion that effort or quality have slackened since DES was implemented on January 15, 1973. The 161 "25" closures in the mentally ill, mentally retarded, and character, personality and behavioral disorder categories are especially significant because they reflect a maintenance of VR effort with interagency programs that have long served these people during the past in Arizona. The State operated Vocational Evaluation Unit in Phoenix continues to play a strong in the overall service delivery system for these difficult cases. The Mental Health Unit in Tucson and a Work Evaluation Unit at the Arizona State Hospital contributed substantially in serving the mentally ill. The mentally retarded have been accorded special effort since 1964 in cooperative agreements with school districts for disabled high school students, especially in Tucson and Phoenix. The 29 rehabilitated persons in the behavioral disorder category were public offenders. All persons in these categories had well-documented psychological or psychiatric evaluations in the determination of eligibility. This has been strengthened even more by the addition of a State Psychological Consultant to the Bureau's staff to coordinate and assure the best possible psychological evaluations and services for handicapped persons. State Legislative support for vocational rehabilitation services to the physically and mentally handicapped has grown significantly in the last ten years. State appropriations for VR have increased from $225,000 which matched only 1,192,603 in Federal funds, to $1,636,800 in FY 74 to match an estimated $6,800,000. See Attachment 6. Since 1971, the Arizona State Legislature has appropriated enough money to match all of the available Federal funds allocated to the State for the VR program. This support has been invaluable during a period of rapid expansion of programs, spiralling costs, and the inability to predict the amount of Federal funding. The availability of State funds will undoubtedly be enhanced by the reorganization as services are integrated, resources are better utilized, and savings to the taxpayers are effected. There is growing recognition by the legislature and the public that there will never be enough money from state or federal sources to serve all of the handicapped in Arizona. We believe that more people will be served with the greater resources now available through DES. Thus our long-sought for goal of services to every eligible handicapped person draws closer to reality. These facts speak for themselves. DES is a people-oriented service organization. We in the Bureau are pleased that we do not have a monopoly on concern for vocational rehabilitation services to the handicapped. This concern is evident within all levels and components of the Department. It is also reflected in growing legislative support, public enthusiasm, and incontrovertible evidence that handicapped persons are benefitting from our mutual effort. ARIZONA STATE PLAN, NOVEMBER 15, 1973 2.3 ORGANIZATION OF THE STATE AGENCY (a) The Department of Economic Security, through its Director, determines, controls, and supervises all administrative policies and standards of the various program and support units comprising the Department. (1) The Department is organized into three major Divisions: Administrative Services Division, under an Assistant Director, provides to all Department organizational components administrative and staff services in these areas: Contracts; research and statistics; data processing services; financial accounting; and support services of equipment control, forms and procedures design and controls, graphic arts, mail and messenger services, printing, purchasing and real estate management. Field Services Division, under an Assistant Director, plans, organizes, directs, and coordinates the provision of all direct services through district and local field offices, and the Central Services Bureau, to clients of the Department. The state is divided into six field service districts, each headed by a District Manager who is responsible to the Assistant Director of the Division for all field services within his geographic area. The Department's six field service districts provide leadership to local offices in which the Department's services of employment, welfare, vocational rehabilitation, and other services are made available either singly at separate offices or in combination via multi-service centers. In either case the vocational rehabilitation portions of the Department's field service operation is an identifiable component and is under the supervision of Department personnel who report to the District Manager. The immediate staff of each District Manager contains a specialist in Vocational rehabilitation services who ensures that policies and practices of vocational rehabilitation within the district are consistent with Federal regulations, State law, and the State Plan; his role is to implement the vocational rehabilitation program within each district, consistent with the policies of the Bureau of Rehabilitation Services. Vocational rehabilitation services are provided through the Field Services Division to clients of the Department who are eligible for such services, as determined by vocational rehabilitation counselors in the local offices of the Field Services Division. Vocational rehabilitation service means a service determined by the Director to be necessary to enable a disabled person to engage in a remunerative occupation, and includes medical and vocational diagnosis, vocational guidance, counseling and placement, rehabilitation training, physical restoration, transportation, occupational licenses, customary occupational, tools and equipment, maintenance, training books and materials, follow-up, evaluation and work adjustment, and other related services as defined in the Vocational Rehabilitation Act, as amended, and in the State Plan for Vocational Rehabilitation. Expenditures for such services can only be authorized by vocational rehabilitation counselors. Program Services Division, under an Assistant Director, provides program planning and technical assistance to all organizational elements within the Department to enable it to meet established goals in the area of manpower employability development, social services, income maintenance and vocational rehabilitation, and to administer special service programs for veterans, unemployed, aged, physically disabled, and families in need of assistance. (2) The Bureau of Rehabilitation Services: One of the major organizational components of the Program Services Division is the Bureau of Rehabilitation Services, the function of which is to support the efforts of the Field Services Division and its district and local offices in securing an acceptable and dignified personal, social, vocational, and community role commensurate with the abilities and interests of each eligible handicapped Arizonan. The Bureau of Rehabilitation Services plans, coordinates, and interprets rehabilitation policy; develops programs and procedures based upon approved policy; supports the implementation of programs and procedures within the Field Services Division; upholds the integrity and quality of individual rehabilitation programs and services; maintains necessary coordination with other Bureaus within the Division and the Department to accomplish rehabilitation objectives; implements approved recommendations from the Rehabilitation Advisory Council, the Advisory Council for the Blind and Visually Impaired, the Professional Advisory Council for Rehabilitation, and such other advisory committees as may be deemed necessary; develops or obtains necessary data to approve contractual rehabilitation programs or to prepare required State and Federal reports; maintains liaison with local, state, regional, national bodies, and public and private organizations to insure the provision of meaningful and efficient rehabilitation services by the Department; provides training in vocational rehabilitation for all Field Services Division, Bureau, and other personnel engaged in rehabilitation endeavors, and provides related program evaluation, research and reference services to all such personnel. The Bureau of Rehabilitation Services provides support to the general vocational rehabilitation client caseload through specific program services in the areas of rehabilitation facilities, Social Security Trust Fund beneficiaries, communication disorders, correctional rehabilitation, medical and psychological services coordination, and other special disability areas. Specialized rehabilitation services are provided for the blind and visually impaired, including services for vocational rehabilitation, business enterprises, sight conservation, and Talking Book Machines; the Bureau administers a blind and physically disabled industrial training facility and a disability determination program for the Social Security Administration. The Bureau of Rehabilitation Services Chief, under the Assistant Director of the Division of Program Services, devotes full time to the administration of the vocational rehabilitation program and is responsible to the Department for all vocational rehabilitation matters and for carrying out the policies of the Department, including Federal regulations and policies set forth in this Plan. He is responsible for formulating and interpreting policy and procedures and for planning, organizing and directing program operations to be carried out by vocational rehabilitation personnel within the Bureau and within the Field Services Division. The formal organization of programs and staff within the Bureau is still being developed. The final plans will require approval of the Department of Economic Security and the Social and the Rehabilitation Services. (b) Program evaluation for vocational rehabilitation will be conducted by the Bureau of Rehabilitation Services. Coordination will be maintained with personnel involved in other evaluation studies for the Department (See Section 2.10 on Program Evaluation). (c) The primary responsibility for public information and program interpretation shall be placed with the Director of the Department or his delegate. (d) Vocational rehabilitation services to disabled individuals, including those rendered during extended evaluation for the etermination of rehabilitation potential, and those planned with and provided to persons found eligible, are the responsibility of vocational rehabilitation counselors who operate under the supervision of district supervisors of the Department's Field Services Division. Vocational rehabilitation counselors are responsible for obtaining medical, psychological, and other evaluation services for determining eligibility, planning rehabilitation services, authorizing the expenditure of funds for rehabilitation purposes, and for coordinating the services with all other services necessary for rehabilitating diabled persons. (e) Vocational rehabilitation services during extended evaluation to determine rehabilitation potential are rendered in accordance with Section 6.1(c) and (d) and Section 10.2 of the State Plan. (f) The Bureau's rehabilitation facility staff is responsible for the establishment, construction, and utilization of rehabilitation facilities. These responsibilities are described in Sections 2.7, 22, and 23 of this State Plan and in the State Rehabilitation Facilities Plan. (g) The Bureau employs a State Medical Services Coordinator who is responsible for providing consultation to the Bureau and to field personnel with respect to the medical and physical restoration policies and practices of vocational rehabilitation, including the development and utilization of public and private medical facilities and medical personnel, and rates of payments for medical services. He is responsible for consultation with the district medical consultants and coordinates their objectives. He has the responsibility of maintaining liaison with the Professional Adviory Council for Rehabilitation as well as other professional groups and individuals regarding medical policies and practices relating to the vocational rehabilitation program of the Department. The Bureau employs a State Psychological Services Coordinator who is responsible for providing statewide consultation to the Bureau and field personnel with respect to psychological services, policies, and practices in vocational rehabilitation, including the development and utilization of public and private psychological services and personnel, and rates of payment for psychological services. He is responsible for consultation with district psychological services personnel and coordinates their objectives. He has the responsibility to maintain liaison with the Professional Advisory Council for Rehabilitation as well as other groups and individuals regarding psychological policies and practices relating to the vocational rehabilitation program of the Department. A program Services Section in the Bureau carries out special rehabilitation programs in alcoholism and drug abuse, plus other programs as designated by the Director which will enable vocational rehabilitation counselors to render better services to their clients and to ensure the orderly development of rehabilitation services and resources. (h) Exploration and development of specialized rehabilitation programs will be a continuous responsibility of the Bureau. As authority is granted and as funds permit, specialists and consultants will be employed to give additional attention to special disability groups and special projects in areas where needed. (i) The Disability Certification Section, under the direction of a section manager, is directly responsible to the administrator of the Bureau of Rehabilitation Services for planning, coordinating, and carrying out the OASI Disability Determination program within the terms of the agreement between the Secretary of Health, Education and Welfare and the State of Arizona and to carry out provisions of Section 221 of the Social Security Act. (j) Vocational rehabilitation services will be provided to beneficiaries of the Social Security Trust Fund in accordance with the plan and policies set forth in Section 26 of this State plan. (k) Specialized programs such as State agency-managed business enterprises, homebound industries, and vending stand programs are described in the separate State Plan for services to the blind and visually impaired. Should such programs become available under the regular program for vocational rehabilitation services, amendments to this plan will be submitted. (1) The Department presently operates two rehabilitation facilities: Arizona Industries for the Blind, under the Bureau of Rehabilitation Services; Vocational Rehabilitation Vocational Evaluation Unit, under the Field Services Division. (m) The functions of the Field Services Division of the Department have been described previously. This Division supervises district and local operations for the Department's integrated approach to delivering services. (n) Research and statistics relating to the vocational rehabilitation program will be the responsibility of the Bureau of Rehabilitation Services. Planning, evaluation, and research studies of a regular or specialized nature will be conducted by the Bureau to maintain the integrity of the rehabilitation program and to meet its objectives. Coordination will be maintained with other research and statistical operations within the Department, where appropriate. |