Webcast: Learning Disabilities Program Outcomes Based on Bridges to Practice - Rhode Island

Transcript - Learning Disabilities Program Outcomes Based on Bridges to Practice - Rhode Island's Presentation

Steven Brunero:
Good morning everyone. My name is Steve Brunero from Rhode Island. I'm presenting alone today. Janet and Judy, who are my colleagues weren't able to attend. I have some information I've passed around. There is a handout that Janet had asked me to present to folks for practice. There is a logo in the corner. Does everyone have one of these? The front page explains briefly about the project. The second page is a program survey that Janet had put together. The third page is a timeline that talks about the beginning, 1995 and '96. The Welfare Reform Implementation Task Force was created and all the different events that occurred with Judy and Janet including the beginning of the New England LD Partnership. In 1998 the RSDHS connection. In 1998, Dr. Pat Anderson's first workshop in Rhode Island. Rhode Island Bridges partner completes survey of LD issues. In '99 and 2000 training on Bridges in Rhode Island - three all-day trainings and the first guide books. 20-25 participants per training. Then in 2000 and 2001 Bob Mason, who is our GED testing Administrator in Rhode Island brought in Neal Stromsky [sp] and Nancie Payne to do a series of workshops - 40 hours total, which was very well received. October 2000 learning disabilities in adults workshops; strategies for instruction. 2001 Bridging the Gap training took place. Spring 2001 training symposium, Washington, DC. Rhode Island is one of the eight states that was invited to participate in that. There were several folks - Elaine Staffton [sp] and Lisa Bead, who are adult educators who took part in that along with eight other members, which I was a part of that also attended. Robin Schwartz came and did an ESOL workshop. A HUB meeting in Seattle. In 12/01 the present Bridges team facilitates bi-monthly teacher meeting. There is more information that Judy and Janet put together about some of the things that they've done themselves in Rhode Island.

When I do my presentation, I'll try to intersperse and make some connections between what the Adult Education Committee of Rhode Island and Bridges practice experience that they've had into what we've done in our project. My project is called The Rhode Island Learning Disabilities Project. I coordinate. I'll tell you a little bit about my background. Right now I'm a supervisor and a project coordinator in Rhode Island for the state Vocational Rehabilitation Agency. The way it is up in Rhode Island, the Department of Human Services is the umbrella agency - DHS. Under that is the Office of Rehabilitation Services, ORS. Under ORS there are three subdivisions. I apologize for this pulpit, or whatever it is. I am going to show you what is underneath this for a second. Under ORS there are several divisions. There is SBVI, which is Services for the Blind and Visually Impaired. Then there is VR, whom I work for. There is also DDS, which is Disability Determination Services. Where I'm coming from is the VR perspective.

It's great to be back here in Maine. I come to Maine every year. I run a white water rafting trip up in Millinocket and Skowhegan, for those of you from Maine. It's another four hours from here, I think. This was a short trip from Rhode Island - only 2.5 hours. Every year we have about 25 or 30 people that drive up to Maine and do the rafting trip. It's usually a lot of fun. Some of you know, my wife is here with me today and my kids. My wife loves to go rafting, she says because of the rafting. On the way home every year she likes to stop in Freeport for L.L. Bean. I'm not much of a shopper. I can run marathons. I've run marathons for most of my life. I can run 26 miles, but to ask me to shop for 20 minutes, I just loose it. There is a physiological response that takes place. I go to a store and look for the first chair I can find. Coming back from rafting, my wife always looks for Freeport. I got wise to that a few years ago. I knew where the Freeport sign was. So I always point out the row of birch trees or something on the other side of the road. She took me one up. She found out about Kittery. When she heard we were coming to present here in Kittery, she naturally decided she wanted to come with us. That's why they are here with us today.

I want to thank Bridges to Practice, particularly NIFL [sp] and June Crawford for bringing this together. I've been fortunate enough to have been to Seattle twice in the last two years for the training academy there. Some wonderful things are happening around learning disabilities awareness, not only in the adult education community, but with state agencies, VR, with Health and Human Services. Our project started in 1998. I have seen a wealth of growth, which has been facilitated by the folks at NIFL. June I want to thank you very much for making this all possible and for bringing everyone together today. Jackie, you've also been very helpful in trying to figure out the mileage forms for us and everything else that you've been doing.

My background is that in 1998 I was a school counselor. I worked for the state VR agency, but I specialized working in schools. I worked primarily with learning disabled students. Then the State of Rhode Island in 1998, the Department of Human services decided to set up a program to address the needs of individuals on public assistance with learning disabilities. There was this posting. I bid on it. Based on my experience in learning disabilities and working in schools, I was selected to start this project. It was a one-person job. I had to develop the whole program, the foundation, learn all about the TANF system in comparison to the vocational rehabilitation services. There are some very different and inherent philosophical and programmatic differences between Health and Human Services and Vocational Rehabilitation. For example, in the TANF program it's time-limited. There is a five-year time limit. Many states also have other time clocks. Rhode Island has a two-year time clock. You have two years to get your education and training. Then you are expected to work at least 20 hours a week or more. In VR there are no time limits. There are no requirements. You have to have a disability that is an impediment to employment, but there are no time limits. There are also work participation requirements in the TANF programs. You have to be participating-in Rhode Island now it's up to 30 hours a week or more. In VR there are no time limits. We understand that people have work tolerance issues. Some people learn more slowly than other people. There are some real inherent differences. It wasn't an easy thing for me in starting out to try to mesh these two systems. In fact, when I took the position, some of my colleagues questioned my sanity. They said, Steve are you sure you want to go work with women on welfare with disabilities. They don't want to go to work. That's a no-win situation for you. I really didn't want to believe that and I really didn't believe it. I set out. I had a mission to accomplish. Both professionally and personally in my life, having some experience with learning disabilities in my family, I felt that this was something that I wanted to become successful. I am happy to say that we have achieved a measure of success. A colleague said that it would be very difficult to get folks to come to appointments. They are lazy. They are unmotivated. They don't show up for appointments and those kinds of things. There are some real, inherent biases that exist both in the community and professionally. Some of those biases and stereotypes still exist. I remember one person saying to me that the folks on welfare are staying at home. They are watching soap operas and eating bon-bons. That was this person's impression of a person on welfare.

So I did a little research before I started the project. I looked at all the data that we had at our state VR agency to see what percentage of the folks on TANF that had been referred to us actually showed up and became clients of the VR agency. The percent was very low. It was 17 percent. I said, there is something wrong with the system. I researched the system. What happened was, whenever anyone-whether it was an adult educator or a TANF social case worker or anyone at all wanted to make a referral to the state VR agency, they would call up the number, 421-7005, explain their situation, and an intake packet would get mailed out to them including an application. I have an intake packet here today.

This is the intake packet. I'll show you the forms. The first form is the Office of Customer Relations brochure. I take the blame for this one. I am the Customer Relations Officer. There is in the information on your right, a VR client. There is a fact sheet, which is two pages long. There is a client assistance program brochure. People are just applying for the service and we are telling them how they can appeal their decision. Then there is the desktop guide to social security benefits and SSI work incentives. There is a discrimination notice from the State of Rhode Island. There is an eligibility form. There is more SSI information. That is just one side. It gets better. This is the application. This is still the application we use today. Demographic information. Look at all the information - we talked about making things easier to read. The inside - education, training, physicians, hospital, disability. The back side, financial information, certification-I hereby certify my willingness to participate - four-page application. Then there are releases of information forms, a lot of legal lingo in them. Self-assessment forms - two pages. Voter Registration Act. I also take the blame for that. I am also the Voter Registration person. Register to vote, if you haven't registered.

My favorite-I've got a copy in the blue folder I am going to give everyone with handouts - is this. This is the map and directions to our office. I can't understand this and I don't think I have a learning disability. It is very difficult to understand. I looked at this. We have a parking garage. Our office is downtown Providence. It's fairly congested. It's a small city. There are directions here to our parking garage so people can find a place to park. They can get a ticket and get it validated so they don't have to pay. I came to work one day. I drive to work every morning in the traffic. I do it blindfolded. One morning I pretended I was a client coming to ORS. I drove up to the parking garage. I noticed there was a sign out front. I had noticed this sign, but I had never really paid a lot of attention to it. It said, if you are going to the Office of Rehabilitation Services, please go down to the next street and enter at the Washington Street entrance, not the major entrance where I usually enter with my card. There is a little side street next to the parking garage. So I said, OK, I came there, I've pulled up. There are people rushing to get into the parking garage. If you are someone who is unfamiliar with that, chances are you have driven up to the entrance way and there are people behind you tooting at you to get out of the way and to get on with your ride. There is a little side street. There is no street sign. There is the parking garage. There is a Macdonald's. There is a little alleyway. I went there thinking, would I take this street or not? I would really not know whether to take that or not because there is no street sign. If you don't take that street-by the way, that is the street you're supposed to take, you have to go down about a quarter of a mile on a one-way street to a street light. Then you are into the city and you are lost. If you are fortunate enough to take that small side street, you are going the right way. There is only room for one car. If a car is coming the other way, you have to back up. Anyway, you go all the way around and come in. That is how you get into the parking garage. That is just to get your car parked. Then you have to walk a block and a half to our building. It is a typical state government building. The Treasury Department is there. Coastal Resource is there. The state VR agency is there. You walk up to the door. There is a security guard. There are cameras. You have to sign in. Then you have to go to an elevator, go up to the third floor, see a receptionist, ask for the counselor, and see the counselor. Now you know why only 17 percent of the people showed up.

The first thing I did was throw away this whole packet. Whenever anyone wanted to make a referral, there is a one-page referral form: name; address; who you are; who made the referral; and a couple of questions. How far did you go in school? What was the last job that you had? Folks can fax the referral to me. They could just call me up - whatever. With that one-page referral, the show rate went from 17 percent to what do you think? Take a guess.

Steven Brunero:
72 percent it jumped up. I can remember one individual that I met that I sat with. We meet with folks anywhere. We'll go out into the community. I meet with folks in libraries. I've met with folks in Dunkin' Donuts coffee shops, in their homes, at the welfare offices. I had one individual who seemed interested and wanted to take part in the program. I remember she didn't show up for the appointment the next day. I was surprised because she sounded excited on the phone. I called her up and asked her what happened that she didn't make it. She said, I got as far as your building. I put my hand on the door. I just couldn't walk in the building. One of the activities that we do in our training, this is a combination of a presentation-training today - is we talk about the characteristics and emotions that people feel on public assistance, being a single parent with kids with all these issues that you have. Fear is one of the real characteristics that we talk about. I'll talk a little bit more about that later. We have to make some accessible changes and programmatic changes even to programs that are used to dealing with people with disabilities. We have to look at the individual and look at what their needs are.

I've got some blue folders. These are some of the handouts that we use in our training. On the inside cover, I've got a Learning Disabilities Project brochure and a resource guide. On the left-hand side, you'll see the brochure. We have a website where folks can apply for services on our website. We have a light house. I had one client who was an artist. She chided me. She said this is not a Rhode Island light house. I don't know if it's from graphic arts, or whatever. We do have a lot of nice light houses. That's our logo. If you go to our website and click on, you'll see that the light house lights up. It flickers around. The Seattle King County Private Industry Council, which is now the Workforce Development Council had put us on as a link, as a best practices link. The Learning Disabilities Project has received national attention in a variety of ways. We are on the welfare information network website. We've been down to Arlington, Virginia at the eight-state symposium. We were also invited to go down in 1999 to the United States Department of Labor's conference in Philadelphia that was done in conjunction with George Washington University and the United States Department of Education. I brought a colleague of mine who is a social case worker, who works in the Learning Disabilities Project. We brought one of our consumers with us-one of our clients. You are going to have the pleasure of seeing her on a video tape. We taped her - about a 12-minute video tape. We have done a lot of different presentations. We have power point and overheads and all these different things. When she gets up there and talks, people are on the edge of their seats listening to her. Her Dad was a US Olympic athlete. She talks about what it was like for her with a learning disability going through school and the expectations of a family in Boston. You'll get to see a little bit of her later on.

We've also been involved in presentations throughout New England talking about the Learning Disabilities Project. It is a small project. Rhode Island is a small state. I know New Hampshire was up here yesterday saying, it only takes 2.5 hours to go from top to bottom. In Rhode Island-from Providence I can get to any office in about a half hour. There are some real benefits to that. June can attest. They teased me in Seattle about being a small state. There are some real benefits to being a small state. I can get to any office and talk to people. Since the Bridges training, we've trained over 160 social case workers, eligibility technicians. Every single social worker and every single eligibility technician were trained in Bridges to Practice sessions. We thought it would be nice to invite a diverse audience, so we invited some of the community-based organizations. The sub-contract providers attended. Adult educators attended. Administrators attended. It was a nice training that we did as a result of the Bridges practice.

I won't spend a lot of time on the brochure. One of the things that we started was the STEP questionnaire on the right-hand side. It was the first screening tool that we developed in 1998. It was just four questions. The S stands for stayed back. Did you stay back in school? The T stands for trouble. Did you have trouble learning or remembering information? The E stands for extra help. Did you receive extra help in school? P stands for physical. Do you have a physical or mental impairment that prevents you from working? One of the other things about the Learning Disabilities Project when we first started is that I was naïve about the types of clients that we were going to get. I thought this was going to be strictly a Learning Disabilities Project. The message that I send in most of the presentations that we give is that learning disabilities do not exist in a vacuum. There are lots of other issues that coexist with individuals. You need to look at the person as a whole and deal with all of those issues.

We like to try a little exercise when we start out a presentation. I am going to ask you to get a piece of scrap paper and a pen. This is similar to the mirror exercise you did yesterday and the exercise the day before. It is a little simple. After you get a piece of paper and pencil I want you to sign your autograph as you ordinarily do. Do we have any left-handed people in here? We are going to do it the same way for everybody for the sake of time. Both feet on the floor on the floor. With your left foot, I want you to make a counter-clockwise circle about a foot in diameter. Keeping your foot on the floor, sign your name while you're doing that. Dominant hand, yes. Keep making the circle while you are signing your name.

I'll get to a lot of the handouts a bit later on. We have a presentation that talks about the Learning Disabilities Project. I like to tell a story. June and I were talking about golf earlier. America is aging now. People are getting older. There are more disabilities. Every year there are more and more folks with disabilities. There is guy, Jack, who is a golfer. He comes home to his wife. He is 75 years old, but he is still a good golfer. He comes home to his wife one day and says, honey I'm still hitting the ball really well, but I'm having a hard time seeing the ball. My vision is deteriorating. I have a hard time seeing where it lands. So Jack's wife says, why don't you take my brother Edgar. He still has very good eyesight. Jack say, yes, but he's 86 years old, hon. She said, but he can see the ball really well. He can follow the ball for you. Jack acquiesces and says he will take Edgar tomorrow. The next day they are on the first tee. Jack hits the ball straight down the fairway. It's a great shot. He looks over at Edgar and said, did you see that? Did you see where it landed. Edgar said, yes I saw it where it landed. So Jack asked, where did it go? Edgar says, I don't know. I forgot. Memory impairments are something that we talk about a lot in learning disabilities. You'll see a little bit about that.

This is our logo for the Learning Disabilities Project. It's the same thing that you see when you go to the website. This is some of the recognition that the project has gotten, some of the involvement. We presented at the learning disabilities conference in '99, which was in Atlanta. I don't know if any of you folks were there. We co-presented with the program in Massachusetts. Angelica Sawyer has a panel of folks with learning disabilities that she presents. We've done the same thing in Rhode Island now. I have a panel of successful clients who tell their story. One is Nicole. I mentioned the best practices, the welfare information network. The Urban Institute Report came to Rhode Island and analyzed our program. They did analysis. They looked at several other states, Arizona and others. They wrote about our program in their guide. Some of the other slides talk a little bit about that. These are some of the things that they mentioned in their report. Rhode Island was selected from the broader states because it represented an example of a state that was taking a harder look at recipients' capabilities rather than categorically exempting any recipient with a medical condition. That means that many states have a C1-B. It's a medical exemption. You can get a waiver from participating in the TANF program. The Learning Disabilities Project never set out to look for an exemption. We are looking at folks' potential and capabilities. We want folks to go to work. I started mentioning earlier that some people thought that the Learning Disabilities Project wouldn't be successful because people with learning disabilities have minor impairments. Most state VR agencies now run an order of selection. You have to be severely disabled or most severely disabled. 95 percent of the people who are referred to us - we've had over 400 referrals since 1998 - have made our eligibility. Very few have not made the eligibility, which shows you the significance of the impairments. I've got some graphs that show the co-existing conditions and the types of disabilities that actually occur. It's a program that looks at the positive aspects of folks and their potential for success.

These are a couple quotes from that report. Hidden disabilities, although they may not be visibly apparent, the potential seriousness and complexity of each of these issues cannot be overstated. This complexity increases several fold when one considers disabilities being confronted by a poor woman with children on welfare now required to find a job. It's not just one issue by itself. This is a number tabulation that shows where the referrals are coming from in the first year. In Woonsocket this past year is screened 871 women-actually 869 women and a couple of gentlemen. We screened with the Washington state learning disabilities screening tool. We also screened with a tool called the un-cope, which is a substance abuse and alcohol screening tool similar to the CAGE or the MAST, if people are familiar with that. We also screened for depression and anxiety. Depression and anxiety we have found are also quite prevalent. In Woonsocket we got the most referrals at the beginning of the program. We haven't publicized the results yet. Probably in the next week or two we're going to publicize results. There were some really surprising results from that study that will become public in not too short a time.

This is the meat and potatoes of the program. It's the flow chart of how the project is set up. This is where we start. DHS is the Department of Human Services. The social case workers, the eligibility technicians, and Displaced Homemakers. Displace Homemakers is a sub-contract provider program that helps. They do workshops with people as soon as they come into the welfare system. Then the community service providers, community-based organizations, Dorcus [sp] Place is an adult literacy program in Rhode Island. I've got a nice book that I'm going to give you that we created with them called the Road Guide to Understanding Learning Disabilities, which is written at about a fifth- or sixth-grade level and talks about different types of disabilities. Also, things you can do for your kids if the kids are exhibiting symptoms of ADHD or learning disabilities. It's a really nice guide. I've got a copy for everyone afterwards. Goodwill Industries is a vocational training program. And adult literacy programs. Referrals come from a variety of different sources. I've had some people walk in through the door or call me up and say that a friend told me about your program. You helped her out. Can I get the services? We do the LD screening. We have instituted the Washington State Tool in some of the programs like Displaced Homemaker and some of the community service programs. Particularly since Janet and Judy have done a lot of training around Bridges, the adult education community is integrated in Rhode Island with the vocational training programs and the TANF programs. We do the screenings. Once someone is thought to have a learning problem they are referred to our project - FIP, the Family Independence Program in Rhode Island, which is a TANF program and the ORS Learning Disabilities Project. The referrals come into us. Then we go out. I mentioned earlier, I was the only person doing this in '98 and '99. Then we hired a social case worker who helped out and integrated the FIP and ORS program. Since that time, I've taken on a new position. I'm managing the project. I've been able to hire a new senior rehabilitation counselor and a new social case worker too to take over. They do most of the applications and interviews. That is another screening process. As you saw, the application is so long. That takes probably an hour to an hour and a half. It focuses on the learning disabilities and the capabilities and potentials.

After the application is filled out, referral is made for a clinical assessment. Some people call them psycho-educational assessments. We like to call it testing. June, I learned this in Seattle. There is a lot of confusion about what is an assessment. What is an informal assessment? What is screening? What is testing? It's testing. It's site testing. We require psychologists to do the site testing that is required by the GED Testing Administration. It has to be a WACE [sp] and it has to be a Woodcott Johnson. That is what we ask our psychologists and require them to complete for us. As you know, the number of folks who get GED accommodations nationally is very under-represented. I think it was less than 0.02 percent in Rhode Island. That befuddled me when I came on. I said that's impossible. If in the general population, it's 15 to 20 percent and 25 to 40 percent in TANF, how come less than 0.02 percent? You've seen in the L-15 form, it's eight pages long. I'm not going to get into a lot about that.

In Rhode Island you have a learning disability and you want to take the registry of motor vehicles test, the driving test. You want to be able to drive a 2000-pound piece of metal at 60 mph on the road, all you need to do is fill out a one-page form saying you have a learning disability. You can get the test taken orally. If you want to get your C&A test through the Rhode Island Department of Health, you fill out a one-page form to get your C&A test done orally. If you want to get your COTA, your Certified Occupational Therapy Assistant test done in a different format, 1.5 pages filled out. The L-15 is very long. Psychologists were telling me, I just did testing for all this time, you want me to fill out an eight-page form in addition to that to get an accommodation. Then we found out the some psychologists are getting the forms bounced back to them because it wasn't filled out the way it should have been filled out or thought to have been filled out. There are a lot of reasons why it was 0.02 percent. There are still reasons why it's under-represented.

To improve that in Rhode Island, whenever we sent an authorization to a psychologist-there weren't a whole lot of psychologists, by the way, we only paid $175 when I started for psych-evals. We've increased the fee. I remember you mentioned $800. We've increased it to $375, so we've been to get a few new people on board. I want to suggest that you do something that we did in our state. We ended up, after the national symposium in Arlington, Virginia, we were at Dulles Airport. Our team of eight people was going back to Rhode Island. It was around the time of college basketball tournament. We called ourselves The Elite Eight at the time. We bumped into the head of the Rhode Island Psychological Association and his colleagues in the airport. We were waiting for the plane for about an hour and a half. We sat there and we rapped. We said, what can we do to get more opportunities for people? We increased the fees. They have a newsletter, the Rhode Island Psychological Newsletter. They said we could advertise in their newsletter. We've got a couple young psychologists starting out that were anxious to start their businesses up. We got some new folks to come on board, which is nice, because as Dr. Anderson said, it's all about choice. We want to give people choice throughout the process including whom they go to see. They may want to see a female psychologist as opposed to a male. We have Dr. Garitto, [sp] who works with bilingual Spanish-speaking folks. We have someone who is Portuguese-speaking. We want to create opportunities and options for folks.

We have more people do psych-evals now, more psychologists. We pay them a little more money. The other thing we did is that I convinced my Administrator to pay an additional $25 to fill out the L-15 form. We get that as a little incentive. And I require my staff, when they send the authorization to a psychologist to do the testing, include an L-15 form. Then they've got that. A year from now or two years from now, we're not trying to go back to a psychologist. They say, I don't even remember that person; I'm not going to fill out any form. We have them fill the form out right away. I don't know what the numbers are in Rhode Island. I was hoping that Jan or Judy would have that. I don't think they've increased as much as much as some of you other folks have seen. Those numbers are gratifying for me to see that happening, that the numbers are increasing. That has been a pet peeve of mine, the low percentage.

Anyway, the psychologists do the testing. If you are going to set up a program or if you have a program in place, I tell my staff, always accompany the authorization with a cover letter requesting what you want from the psychologist. Even if it's a psychologist who has been doing testing for your organization for years, be specific about what you are looking for. If you want a diagnosis, ask for a diagnosis. If you want functional limitations for eligibility purposes, ask for functional limitations. If you want accommodations for a GED, ask for the accommodations request. We've got a couple folks who are good at it now-the psychologists. We have a psychologist on staff who reviews every single psych report that comes back and gives his opinion on those. He'll tell us if he thinks someone is eligible. He'll tell us if he thinks a person can be successful in a GED program. I have to say, I'm probably going out on a limb saying this in a group of adult educators, but there are a number of folks who have been referred to us who are never going to be successful in a GED program, who have been stuck in programs for years. I've sat down with some of these women. I've shown them that they've got a learning disability. I can remember sitting in a meeting in Rhode Island with someone from-I won't mention who it is because this is being taped. He came out and said, how can you-how dare you label these folks and stereotype these folks as being learning disabled. That was his approach about that. I tried to explain how legally to be eligible for services so we can help people, we need to have the learning disabilities diagnosis.

In order to get the services that people need, we have to do the testing. We have to get the diagnosis. We have to get the accommodations that they require. Often times we get reports back that show that that person will not be successful. When I sit down with folks, for the most part, when I sit down and explain to them-I don't come out and say, you've got a learning disability. That's it. You go on. In our training I sit down and do role play on how we present the information. Everyone is a little bit different. You get to know how people will respond to things. I explain how they learn in a different way. Sometimes if someone has shown that they don't have the capability or potential to be successful in GED, I'll suggest that to them. I'll say, instead of going five days a week, four or five hours a day, you may want to go a couple nights a week and think about a vocational training program. Usually those folks are very relieved to hear that from us. They'll say, I'm frustrated. I've been doing this for years and years.

It depends on the individual. One of the first clients that was referred to me was a woman in Providence who had failed the GED test, I think, seven times. I have to admire the desire and the will to succeed. Has anyone ever read Paul Gerber's report on highly successful adults with learning disabilities? If you haven't, read that. It talks about the intrinsic and extrinsic inherent qualities that people have. One of the qualities is the desire to succeed. This young woman had the desire to succeed. I never would have gone through what she had been going through at this adult literacy program. We got her tested and found out she had a learning disability. She had the potential to succeed if she could get some accommodations. We got her the accommodations. She took the test. She passed the test. She became a teacher's assistant and now is going back to the community college to get an associate's degree. That is a woman who had been frustrated for years and years. It depends on the individual. Some folks have the potential. Some folks don't.

So the eligibility determination is made. If no, we refer them back to a DHS case social worker with recommendations. I tell my staff don't just say, no they are not eligible, your problem, and wash your hands. Recommendations are made. Some folks have been found to have learning differences or learning difficulties. We'll make recommendations for vocational training programs and maybe some adult literacy programs, things of that nature. If they are eligible-most folks are - we develop an employment plan. You've heard of the IEP? We do the IPE. It's an Individual Plan for Employment. It is a comprehensive report. The TANF agency-the social case workers like it so much that they use our plan for employment as their vocational plan in the TANF agency. It's comprehensive. It includes all these different programs - vocational, counseling, and guidance, which is ongoing. We talk about momentum in the service delivery system. One of the key things is not losing people. Folks have had the courage to come to us, to make the phone call and meet with us. We sit down. We always tell them about some of the positives that they can expect, instill a sense of hope because of the hopelessness that exists. When we do that, we want to be able to maintain some momentum. After they meet with the counselor here at the application process and they leave our office, there are probably a couple of weeks before they go see the psychologist. We want to make sure we don't lose people during that timeframe.

In your blue folder on the right-hand side, you'll see a STEPS Action Plan. Pull that out for a second. The STEPS Action Plan is something we created to write down-yesterday Pat was talking about her wonderful program that she does asking the right questions. I mention writing things down. Sometimes people tend to forget. After we go through the whole process in the intake, we always ask people. What did I say? What are we going to do now? We talk about that. We devised this so that when people leave the office, they know exactly what they are going to do. We'll write it nice and neat. Usually the first step is that I'll give them the psychologist's phone number. I'll say, tomorrow you can call psychologist Dr. so-and-so and set up your appointment. Tell him who you are. They are going to get an authorization in the mail from me so they will know what it is about. I empower them to be involved in that process. Step number two might be to call these two or three adult literacy programs in your area. See which one you like the best so you can become involved in that. Step three might be to call Steve back on Tuesday. Let him know when your appointment is. Step four is to call me after you have the test. We can talk about what that was like for you. At the bottom is our next scheduled appointment. They leave this. The form is two pages. They get the white clear one. The counselor gets the yellow one for the case record. It serves two purposes. It helps the client to remember what their responsibilities are, what they need to do. They walk away with something tangible. It helps the counselor. All the counselors are overwhelmed. They've got 200 cases, 180 cases, etc. This will help them to be accurate in [unintelligible] the data. They will know exactly what to put down in the case record and who is responsible for what. It's a useful tool that we've compiled.

That is done at the application. Folks have that. When they come back in, the counselor explains the results of the testing. We have some psychologists-they can ask - who will explain the results. We have one doctor in Newport Hospital who is a great guy. He said, I'll sit down and explain the results with you. I said, great. I didn't even think to ask him-ask the question. I'm going to ask all the time now, every time I do an authorization. Will you explain the results to the client? You may get more no's than yes's, but you will get a few yes's. We sit down and explain the results with or without the psychologist and the recommendations. We'll go over those.

Usually there are adult literacy programs that are involved. Classroom accommodations are big. I guess if folks are going to be needing accommodations, whatever the accommodations might be, it's nice to have those accommodations in the classroom. I'm going to talk a little bit about assisted technology, which is a big part of our program that you don't hear a lot about. I buy lots of Franklin spell checkers and alpha smart portable word processors. I had one student, who had ADHD with learning disabilities, a young gal. She kept breaking the Franklin spell checkers, those LCD displays. The kids backpacks are so heavy. It was getting compressed. She would come home with it. The LCD display would be broken. I got one of those scrunchies, [sp] I think they call them. It keeps the soda cans cold in the summertime. I took the bottom out, put the Franklin spell checker in it. So that it wouldn't fall out, I got some duct tape and taped it around. She went to school with this thing. It looked like something from outer space. It worked. It finally helped her out. We buy lots of those to help people with their spelling. Some of the new ones are phonological. If they spell phone f-o-n-e, it will recognize as phone. Those are some of the accommodations that we'll recommend.

This is a big area that I think was missing in Rhode Island. We've done a lot now lately. Life social skills. I think someone talked a little bit about a program yesterday in New Hampshire. The personal development life social skills. We're doing a good job in education. We're doing a good job at vocational. But some people go into work and don't know how to interact with a co-worker or how to respond to a supervisor. I had one woman who got a job. She was on the job for about five days. She called me up and said, I lost the job. I asked her why she lost the job. She said, I had some difficulty with my supervisor. I asked to explain to me exactly what happened in detail. Her boss told her that either she had to do it this way, or else. She said, I took the or else. She was proud of it. I said, we're going to sit down and talk about work ethic, being new on the job, making sacrifices as a new employee. These are the kinds of things that a lot of folks who haven't work really don't know a lot about. The experiences that the folks have had are so limited, in some cases, negligible, that it's important to teach the social skills, the life skills, not invading someone's body space. Some real basic stuff needs to be taught. That is something that we're trying to work on. We contracted with the YWCA in Providence. We had a wonderful gal that taught a seven-week personal development workshop. How to cope with change. How to dress for the workplace. How to respond to your supervisor. Some nice basic stuff. They also had a dress shop. After they passed and had the graduation, they could get a nice outfit and go to work.

One of the most rewarding and gratifying-I always say this. This job has been the most gratifying for me as a counselor. I've been a substance abuse counselor. I've been a mental health counselor. I was as HIV-AIDS counselor at the Rhode Island Department of Health for years. The folks that I have been successful with are the most gratifying. I've got cards. I save every card that I get because they are so grateful to be provided the opportunity to be successful after being thumbed down for so long. It's very rewarding as a counselor.

The life skills, social skills, vocational evaluations. VR is big. We do a lot of vocational evaluations of all different types. Job training. Community work experiences. Job development. Placement, etc.

The average time from start to finish in VR agencies - does anyone have any idea how long the average success rate takes from initial application. It's about three years. If you are in a program that is a two-year program, you've got to change and modify it somewhat. We have been able to make some modifications to the programs. For example, that YWCA workshop, usually our agencies will not pay for any services until someone is eligible. They can pay for evaluative services. We were able to call that workshop an evaluative service. It helped with the momentum in service delivery. As soon as we met with them, we could get them involved in a workshop right away. They feel like they're involved in something. Sometimes you need to tweak the program so that two different programs coincide.

Then, successful employment outcomes. The first year I think we had three or four. We're up to about 16 or 18 successfully employed individuals a year now. We do about 50 or 60 eligibility terminations a year. In order to be considered successful by the state VR agency, you have to be successfully employed in an integrated, competitive employment situation. It can't be supported employment or a sheltered workshop or things of that nature. It has to be minimum wage. It has to be for 90 days. Most of the folks that have been successfully employed have stayed with the job. The retention is an important component. C&A, I had one gal who came to me who wanted to be a C&A. She was from Liberia. She had-she was a little bit suspicious in the initial application. Why do you need to know all this information, these questions, this and that? It took awhile for us to develop a relationship. We finally had her tested and found out that she had a significant learning disability. She decided that she wanted to go to the C&A training program. It took a long time with a lot of accommodations. We even paid for a private tutor to help her out. She finally passed the test. She got the accommodations in the C&A test. She went to work and called me up a few weeks later. She was having some difficulty. We're still there for people after they get their jobs. I asked what the problems were. She said she was having a hard time reading the blood pressure cuff dial when she was doing those evaluations, taking blood pressure. I didn't know it at the time. You should test everyone for vision and hearing. We do that now. I sent her for a vision test. The test results came back. She was legally blind in addition to being learning disabled. I was blown away. We sent her for corrective lens. She got some glasses. I did some research on assisted technology. There are talking blood pressure cuffs that tell you what the readings are. We purchased one of those. It was about $150. She went back. She is still a C&A now. She still calls me up to this day. She is very grateful. She sent me one rose when she was successful. I kidded her. It was actually my anniversary at the time. I told her I was going to take this rose home to my wife. She said, don't you dare do that. It was an example of assisted technology that was helpful for someone and rewarding.

This is stuff that is probably more up your alley. This is educational information - highest grade level completed. I think national numbers are around 50 percent. If you notice, 24 percent graduated high school and went beyond. Five percent went beyond. That is 29 percent. That means 71 percent of the folks who are referred to us hadn't graduated high school. In fact, 45 percent didn't make it past ninth grade. Just going back to that STEP acronym. Did you stay back in school? Did you have trouble in school or learning information? Obviously there are some real deficits educationally. This talks about the numbers. 71 percent. 45 percent. As we know, low literacy is a real issue with folks. It's not just literacy issues, as I mentioned earlier.

Folks that were tested. Learning disabilities do not exist in a vacuum. Only 42.5 percent through '99 had one condition when they came back from the psychologist. 40 percent had two conditions. 17.5 percent had three or more conditions. We had some folks whom my colleague and I called laundry lists - multi-axle diagnosis. Even though they came to us because they had trouble learning or remembering information or had trouble in school, there were many other issues that were out there and that are still out there. That is why it was important for us to develop a program that took a look at individuals and their needs.

This is from the Urban Institute and their report, some of the things that they've picked up. More than one-half tested had multiple diagnosis. VR respondents - that is vocational rehabilitation clients in both Phoenix and Woonsocket. We now know that TANF clients referred to MC are more in need of intensive help and support due to a combination of significant barriers and disabilities. Folks are interested in what kinds of disabilities coexist. I've got a pie chart. I looked at the pie chart last night. It didn't meet Pat's requirements. I threw it in the corner of the room. My boss took a look at this and said, Steve, you're running a Learning Disabilities Project, yet only 51 percent of the people you tested had learning disabilities. There is a lot of controversy around site testing. A lot of folks tested in the '70s, borderline intelligence it's called by some psychologist, low functioning. The important thing is that 95 percent of the people we had had some literacy issues around learning difficulties.

With the state VR agency, it doesn't make a difference in terms of eligibility, if you are borderline intelligence, mild MR, learning disabled - you're eligible for services. The folks who are referred to us are still eligible. We still work with them. What was very surprising was depression. 29 percent of the people tested for depression. I thought it was high, but I didn't think it was going to be that high. That is major depression or dysteimia. [sp] - very high. Anxiety and panic disorder - 11 percent. ADHD was nine percent. Personality disorder - 8 percent. Mild MR - eight percent. All other, 24 percent. I have some of the latest information here. I don't have it in a graph form. It's similar. The numbers are about the same-the borderline and ADHD. What was significant-what has changed is the anxiety and panic, which also includes adjustment disorders. That includes women who have been abused, trauma, post-traumatic stress disorder, those kinds of things. It's very high. That has gone up from 11 to 26 percent. Remember this is program that has gone from 1998 to 2002. Welfare roles are decreasing in most states. What is happening to percentages? People with significant disabilities is increasing. Many of these are people who fell through the cracks and haven't been able to access service delivery. The other thing that was surprising was that mild MR went from eight percent to 17 percent. Those are folks with IQ s below 70. Everything else was about the same. ADHD was five percent.

Offscreen participant:
Is your finding - is the likelihood that these people existed in the past that they weren't getting to the service?

Steven Brunero:
I think-that's a hypothesis. They haven't been able to access services. They haven't had the wherewithal, the information. We've been paying people to stay at home. We're seeing more and more folks that are coming to us thinking they have a learning disability, remember. They are being tested and we're finding out that there is-a lot of this stuff, we know at the application. When I sit down with someone, people will often times spill their hearts out to me. They haven't had someone who has really listened to them. They are going to hear Nicole. She is very frank about how her first interaction was not a positive one. She tells it like it is. We try to-it's like a cliché, like the old AT&T commercial. We try to reach out and touch someone. We make that phone call. I'll remember some of these phone calls the rest of my life. You talk to someone. You reach out. You can really connect. You see that they, for the first time in many, many years-maybe the first time in their lives have a sense of hope. You don't want to lose that. When we do make that appointment, it's important that we have them involved. We're finding out that when we sit down and meet with them, they have been sexually abused. They have been traumatized. They have been called lazy, dumb, stupid, unmotivated by husbands, parents - all kinds of issues. Those number were a little bit surprising.

These are an example of some of the barriers to employment. Often times I do an exercise at this time. I don't know what the timeframe is. I guess I'm getting close. These are some examples of barriers to employment. Less family support. Less work history. Lower self-esteem. Less education and lower literacy levels. Most often single parents with child care. We see very few two-parent families. More special-needs children to care for. More transportation problems. More likely to be victims of abuse. This is an area that I was naïve about. One of my successful clients was a man. A gentleman who is on our panel. He is going to speak at a conference for us next week. A single dad who had a daughter who was nine years old. She went to Meeting Street School with severe physical disabilities. He didn't want to go back to school and get his GED. He wanted to be a truck driver. That is all he ever wanted to do. He had a child. He was determined. This guy had the desire to succeed. We got him into Nationwide tractor-trailer driving school. He needed a lot of support. They provided extra help. We paid for another tutor to give him help at home. It came down to-he had to take a series of tests. The school department was responsible for paying for the educational program of his daughter. They had an after-school program that went to 3:00 or 3:30. He needed to go to school until 6:00 at night. He had to take this series of tests to pass. We collaborated with the town of East Providence. We collaborated with the Division of Mental Retardation. They have the EPSDT program. Finally we were to get enough funding so that we could get extra tutors for him. The point that I'm trying to make is that often times it is very difficult for a parent with a child with a special need to be successful. They feel-the one connection that they've had in their lives is with their children. They don't want to break that.

One of the first clients that I had was a woman who was a C&A. We got her the extra tests. She took the job. She was on the job about a month and a half very happy and pleased that she was back to work in a job where she felt rewarded. She had a child. This was around the time of Columbine right at the beginning of our project. Her son had some behavioral issues in school. The kids were making fun of him. He brought a knife to school. The cops were called in. It was a big deal. They arrested him. He ended up in front of the court system with his Mom who was very close to me. She called me on a regular basis. She called and asked what she should do. She went to court. The judge was going to remand him to the juvenile training school for several months. Mom was begging, please don't take my son away. The judge said the only way that I won't is if you promise to stay with him 24 hours a day. Naturally, what do you think she did? She promised. She lost her job. She still isn't working to this day. She has gone on SSI. She has had a lot of problems with depression. She was doing really well. The point is that there are a lot of other issues in people's lives that make it difficult.

SSI sometimes is an option. We don't look for that as a way out, like the C-1Bs-medical exemptions. We're seeing more people now who are referred to us with mild MR. In order to be eligible for social security, if you have mild MR, you also have to have a coexisting condition. If the scores are in the 60s, you're not automatically eligible any more. You have to have a coexisting condition. In her case she also had depression and other issues so she was eligible.

The point is that there are a lot of different issues. We'll do a quick exercise. Let's break up. How about two people. You guys will have to go three, I suppose. Three there and two there. It's about a 90-second exercise. I want you to think about what we have found in our survey in Woonsocket. The average is 28 years old, single Mom, 2.3 kids, ninth grade education, and a variety of other issues. Think about the things that I've been talking about. On this piece of paper I want you to think as a group about all the different emotions and characteristics that these Moms are feeling. I'll have you report out. We'll make a list of them. I'll give you 90 seconds to do that. About 30 more seconds.

Offscreen participant:
I want to know who pays your salary and why we can't get one in Vermont.

Steven Brunero:
You can. In Rhode Island we approached the Director of the Department of Human Services and said, it would be nice to create a program where the VREC can interact with the TANF agency to help folks with learning disabilities.

Steven Brunero:
No, it's DHS money. My salary has been paid out of the DHS account. It was a couple hundred thousand dollars. It paid my salary----

Steven Brunero:
Yes. If you have someone responsible for that, then it helps to make the connection. Someone who is accountable.

I want to bring your attention back here. We'll start out with Pat and Martha. What are some of the characteristics or emotions that you think folks feel.

Steven Brunero:
I'm going to stop you right there. Usually I don't hear that until the end. That is one of the key characteristics. There is a quote that you'll see in a moment. I don't know if anyone has read this book. No One is Unemployable by Deborah Angel. She has got a quote in there that says, "fear is often masked as laziness or un-motivation". Usually I have to drag that out of people.

Martha:
It's probably couched as the lack of support from people. You can't do this. You can't do that. You're lazy - all those kinds of things.

Steven Brunero:
That's probably even worse coming from someone in your family.

Martha:
Questionable intelligence levels; learning problems; concerns about child care, housing, and other issues.

Martha:
Difficulty processing and organizing information. That's as far as we got.

Offscreen participant:
We had a lot of those. Also we were on the flip side. She could come in energized. She could be creative. Sensitive, compassionate. 17 and 18-year olds are not overwhelmed by what they should be overwhelmed by. It's not all negative. Gerber and Reefe [sp] wrote that wonderful about adults who have succeeded who have ADHD and all these other things. They also have things that we don't recognize. They are getting along on a lot less than I could. They've found out how to do and get around in the community without transportation. You don't do that if you're not creative and resourceful. They have these other things going on too that makes it even more remarkable that they can do these other things when I would be so totally----

Steven Brunero:
That assessment-that report we talk about intrinsic and extrinsic qualities. Some of the extrinsic qualities are [audible] of fit. They are a lot of intrinsic qualities that you mentioned here that are also good points. Another one is re-framing - the ability to reframe a difficult situation that is in a way that is easier for you to function and process. Those are good. Do you have some more?

Offscreen participant:
Going along with what they did, I'll throw this in. When I do my new staff training, one of the first exercises is to have them give me all the characteristics they think the adults have coming into their program. We put them up on newsprint. 99 percent of the time 99 percent of the characteristics are negative. That leads to a good discussion. If that is what you see, then that is the way you approach the clients. You don't focus on what can happen when looking at the positive side.

Offscreen participant:
I remember one man who came into an adult ed program that we had. We were trying to find a fit for him. He hung around the building for a long while before he walked in. Eventually he walked in and sat down. We were going through this interview process. We were trying to ask him what he had done for work. He finally was all these things that you would see as someone who would look depressed, anxious, resentful, a little distrustful. Finally he took out this wad of money and put it in front of me and the other interviewer. He said, I make a lot of money selling drugs. Our immediate response was, you must be a good businessman. What are our entrepreneurial skills like? To be able to see that this man had-he was ashamed and embarrassed. On the other hand, he was a whole lot more successful than I've been financially in how he invested his money. You have to start with people, build on their strengths and recognize them. If you come into this situation thinking that they are so downtrodden and beat up inside. Everybody is horrible to them. All those things are true. There is within them, these wonderful ways of being resourceful in an environment that most of the rest of us would have a very hard time with.

Steven Brunero:
It's so true when you think about it. A lot of the folks who come to me are single Moms. I'm fortunate. I'm in a two-parent family. I have a hard time myself functioning. Single Moms, three or four kids sometimes, $450 a month. You've got to pay rent. You've got to get food, clothing for the kids. They still function and get by.

Steven Brunero:
That's a great answer. I am going to remember that the next time he mentions it to me. How about you and Jackie? Do you have any other qualities?

Felicia:
Alone and isolated. Finding it hard to make ends meet. Little or no support system. Also, if this woman is able to get a job, one of her primary concerns is that she is going to need clothing and accessories in order to fit in at that job.

Steven Brunero:
OK, we don't have that yet. Hopelessness is a biggie. I hear that one a lot.

Offscreen participant:
Anger and frustration. I think one that I thought of after the perky people talked was an anxiety and anxiousness to succeed. The anxiety of not everything is so bad, but I need to get out and do it and get on with things.

Steven Brunero:
We see that. We talked about fear of failure and fear of success. These are folks that are fearful of success, fearful of going off that check that comes in all the time. What is going to happen when I do get a job. What is going to happen to my medical assistance? Fortunately in Rhode Island we'll keep people on for 18 months. They get medical benefits. We've increased the poverty level to 250 percent above the poverty level. Even though someone gets a job, it's reassuring to them to know that they will still have medical assistance, particularly for their kids if they need that. Fear of success is a biggie.

Offscreen participant:
The other thing that we talked about was feeling protective of their children and not wanting to leave their children. Also the whole societal thing. You are supposed to take care of your children. How can I go out and work when I have to take care of my kids?

Steven Brunero:
I hear that so often. I can't go to work. I've got to watch my kids. We talk about how we'll pay for child care. They say, I can't send them to anyone. There are certified child care programs that are checked out by DCYF. BCI checks have been done on everyone, so they are good programs. It usually takes awhile to get people to slowly feel comfortable with that, letting their kids go to someone else. You hear that a lot.

This is an exercise that we do. We talk about some of the characteristics and emotions. I want to quickly go through. This is that quote that I mentioned to you from Deborah Angel. "Sometimes you have to nurture a recipient into treatment over time. Recipients begin to believe that staff care about them and their well-being." That was from the Urban Institute when they looked at our program. I'm not talking about the kind of nurturing where you are doing everything for someone, you are obviously not empowering. Feeling a sense of security that we are here to help you out. Yes, call up any time. If you have a problem on your job or in your program, talk to me about that. We can see if we can help you out.

Intensive case management is one area. Since I've been going to conferences, it's an area that is really important in a program. Average case load in TANF is somewhere around 150 to 200. Average case loads of ER counselors is 150 or so. I think that in order to do a successful and a really good job, you should have no more than 65 clients. The needs are more intensive. People are dependent. They need to call up and clarify and get reassurances. In order to nurture and do a good job, I don't think you should go over that number. It's important. This is Deborah Angel's quote. "Fear is often masked as laziness, lack of motivation, blaming, etc." Reaching out increases the attendance rate of FIP recipients three-fold at initial interviews. That is what I mentioned a little bit earlier. By reaching out and developing a relationship with someone, chances of their not only succeeding but participating increases about threefold.

One of the things we do in our program is we have seminar satisfaction forms. Our administrative support person sends out customer satisfaction. What was the program like? What helped you? What didn't help you? What would you have different? This has been good in driving our program strategically to make some changes in the program that we feel are important to make. This is a first initial---- .

What type of assistance do you feel would be helpful to you now? Just a lot of awareness in the workplace about people like me, so when I do go for a job interview, I will feel free to talk about it. I went to my first test at CCRI, Community College of Rhode Island, to get GED. This is the way she wrote it, word-for-word. It was the math test I took first. Boy, was I stressed out. Thank God I had extra time to take the test. Yes, I passed. She put a smiley face in there. I don't think I could have passed if I didn't get tested at the Rehab and if the Rehab didn't give me more time. Thank you.

To talk about the gratefulness and the appreciation that people feel for being able to get accommodations and the help and someone to listen to them that cares about them.

These are some of the keys to success that we had written down over time. Personalized approach. Maintaining momentum. Detailed and comprehensive employment plans which address educational, vocational, life social skills. Having experience with community service providers and resource development. There are some programs that excel in one area, but not in other areas. Sometimes they don't excel in areas they tell you they excel in. It's important to know about the programs, know about the resources. Some adult literacy programs are very good. They have multi-sensory programs like Orten Gillingham [sp] and the Wilson System. One has Scottish Write. Some of the programs are very good. Some excel working with people of color. It's good to know about what types of programs do better than other in what areas.

This was done after Pat Anderson's project yesterday. All staff committed to working on a common goal. Objectives must be clearly described. We have goals and objectives. Every year I list about 20 different goals and objectives for our project. The first year we made all of them, the second year maybe 18 out of 20. We do a good job of trying to stay on track with what we're trying to accomplish. Education and staff training. Staff needed to be trained ongoing. We did it once a year. I go back out to the field offices. They ask what a learning disability is. They have got to go back over and over again to make sure. There is a lot of staff turnover that occurs. There is new staff. People doing different jobs. Ongoing is important. I know Bridges to Practice preaches that also. Successful program design strategies. Institute LD screening. Local versus statewide. We put that in there because what might be a drawback? What are the benefits of local versus statewide? What do you folks think?

Steven Brunero:
You reach more people if you go statewide. That's a benefit. Can anybody think of a drawback with that?

Offscreen participant:
Let go of individual kinds of accommodations or attention or adaptations to particular groups.

Steven Brunero:
Right. What you are talking about is resources. Some people have said, you're doing such a great job. Let's go screen everybody. If we screen everybody and we give them a diagnosis of learning disabilities, you better be ready to service those folks. The resources need to be there. We did a pilot in Woonsocket, 871 people screened with those four screening tools. We had resources in place. Every social case worker knew all the resources. The Mental Health Agency, if someone disclosed that they were suicidal, they knew the emergency hot line to call. If someone had adult literacy needs and they were bilingual, which program to call. The resources were in place. We went out there and did that. It worked well. To go statewide with that right now. I don't think we're ready for that. You need to be sure that the resources are available.

The other thing, results and outcomes. The one thing that I hear when I go back to social workers, what happened with so-and-so? Who referred so-and-so to you? I never knew what happened. Fell into a black hole. In your book, there is a blue page memorandum. I did these color copies before yesterday's session. This is a memorandum we created so we that could respond back to social case workers. It's a carbon copy so it doesn't look that good, even though it's a pretty blue. Complete an application for RS services and awaiting evaluation. Signed an OS employment plan and the date. A copy is enclosed. Reports they found employment. That is always a good one to cherk off. States he or she is not interested in OR Services. Sometimes people don't want it. It's a voluntary program. We can't force them. Did not respond to efforts by contact, phone, or letter. It happens. A lot of folks move. Did not appear for scheduled appointment. Please feel free to contact me. Social case workers say, we want to know what's happening. If we make a referral, they have to see that their efforts-they've got to fill out that one page referral form. They want to see some results. What are you doing with someone? If you have a plan for employment that you send them, obviously you show that you are doing your job.

Some of the other things. Outreach information dissemination. We do a lot of outreach. Anne, Louise, and myself were just talking about the integration of our service delivery system. It's a small area. You can do it in the larger states and regions. Integrating the system so that the adult basic education teachers, the vocational job developers, the TANF social workers, and the VR counselors are all sitting at the same table. We're all on the same page. We know faces. We can talk to each other. Resource development. I talked earlier about psychologists LD testing recruitment. We're continuing to do that. Increasing the fee schedule for those folks was important.

Program review. My initial supervisor is a program evaluator so very detail oriented in making sure that you are reviewing the program ongoing. The program evaluation, I think, needs to be both internal and external, not just having a supervisor or an administrator that you're doing it for, but also externally hearing from your colleagues in other areas. What is important to them? If we are all going to work for the same common goal, if we are going to instill some hope in people's lives, we have to believe that they are going to be successful if we want them to believe that they are successful. We all have to be on the same page to be able to do that.

There are a couple of handouts that I want to bring to your attention. There is a nice pink one. This is from one of my first students who is very dear to me. She came to my attention because they said that this young gal wasn't trying hard enough in school, wasn't working up to her potential, etc. She seems bright, but she's not doing very well. She had an IEP. The psychologist had her evaluated. One of the things he had her do was write a day in the life of her diary. It was time limited. She obviously had some spelling errors. I'll read it to you. I've read it enough times so that I know what some of the words mean, so I'll read it for you folks.

Dear Diary, today I went to the dirt pile. I think that the huge, brown piles are very special. Today some people are just piles of mashed dirt with some flowers and rocks and a couple of trees. I went there with my dog, Shila [sp] you know the huge which one. While I was sitting under the small plant making purple dye by crushing the berries with a stick in a dug-out hole in the ground. As I was sitting down on top of my hill with the berry in my lap, I decided that it was one of my favorite pals. I watched the sun dip low into the soft clouds, the dipper leaving a trail of exquisite rays over the pink clouds. Finally I decided that it was time to go home. I picked up my berries and headed in. Suddenly I felt as though my heart had gone through my throat. My house was gone. You diary, was the one thing left on the ground where my house had been. Now you know how my little Indian life began.

Steven Brunero:
This is a gal - creative, very vivid imagination. She is a nice artist. She writes poems. This gal was sent to me because they said that she wasn't going to be successful in the regular language arts program. Her spelling is poor. She is not trying hard. They were very concerned about her so they had her evaluated. She tested out-I think her IQ was about 118 or 119. She now is in high school and has honors. It's going really well. She had real trouble in elementary school, real trouble in middle school. The IEP that I went to was so adversarial. We went there to talk about this young girl and her strengths. The team there said, that Dr. so-and-so, he diagnosis everyone with ADHD. We have open classrooms. That is always we've done it. It's not distracting. It was unbelievable. This is a young gal who has come a long way. She is never going to be a good speller. She always misspells the same words. I've seen a lot of her work. An example, some of the problems that she has. The word boast is b-o-a-s-t. Toast - t-o-a-s-t. Roast - r-o-a-s-t. Whenever she spells "most", how do you think she spells it? I've told her 100 times how it's spelled, but she always spells it the same way. Very is another one. It's always v-e-a-r-y. I don't know where that "a" comes from. Obviously she's got some phonological deficits. She has problems with decoding. She has got such a great mind. She creates such nice literature. Some of the teachers that are out there couldn't look at her that way. She has a teacher right now in high school. I think she's a sophomore in high school. The first day of class I got a chance to meet this teacher. The teacher saw some work that she had done and said, this is a really special student. She said, don't worry about the spelling. I'm not going to take points off for spelling. I know she's not going to be a good speller ever. I'm not going to care about that. I'm more concerned about her content, what she's thinking, and how she organizes it. So she has done well. That is an example of one of the students that we have.

Also, on that right page, I'm going to go through a couple of these quickly. There is a learning disabilities characteristics checklist. Sometimes I will modify that depending on the audience. I think someone mentioned a good idea if you are talking to clients, you can talk about some of the characteristics both positive and negative.

The page - these are some recommendations for our project that existed over the last year. Continue to expand staffing of the LD project. Replicate the Woonsocket project on other sites. Advocate for more staff. Everybody is advocating for more staff. I think all states are facing a budget deficit. In Rhode Island it's $50 million to $400 million. In order for me to come here today-there is restriction on state travel. No more out-of-state travel. I had to use my vacation time to come here to present because there is no more out-of-state travel. I was more than happy to do that. It shows you that even though you are doing something successful, it's hard to get the resources often times.

There is also a copy-I'm not going to go through that. We do training. We use the Washington State 13-question screening tool. Often times we'll go through an exercise with that. I'm not going to do that. On the left-hand side there is a sample LD quiz. Originally I was going to have you do a pre-test and then do a post-test afterwards. I'll spare you that. It's our last day here. The last piece of information I want to bring to your attention is the form bio-nexus. Folks in Connecticut may or may not have heard of this program. They are from Connecticut. It's an assisted technology rehabilitation engineering program. Many of the folks that get referred to us at learning disabilities-I have these folks to a rehabilitation engineering evaluation. They make suggestions and recommendations. You'll see some recommendations on pages one and two for this individual. The last page is a copy I made of one of the things that we purchase often times. It's a Merriam-Webster speaking dictionary and thesaurus. These are kinds of accommodations that your state programs can provide. Don't let your state programs tell you that learning disabled people aren't going to eligible or adult education clients aren't going to be eligible because learning disabilities are not helped in the VR program. We are on an order of selection in Rhode Island. 95 percent of the people referred to us are eligible. Your state VRs can be a resource for you. I can't say enough about the collaborative interaction between the Department of Human Services and the State VR agency in bringing in the community service providers and the adult education community to work together with a common goal.

I'd be happy to talk to any of you folks afterwards. If you want to develop some sort of program in your state, I'd be happy to help you with that. That's it.

We've got a 10-minute video. Is that alright June? Do we have time for that? Let me move it so that everyone can see it.

Offscreen participant:
Steve, I have a quick question. The [inaudible] little girl [inaudible]. Was she sent to some kind of tutoring that gave her that? Obviously she has [unintelligible]. Did she get into that [unintelligible]?

Steven Brunero:
She got resource help in middle school, but did not want-she was a young lady who did not want-she used to take medication. She would take rydelin and anaderol for ADHA also. She didn't want-they would call her out of the classroom to go get her meds at a certain time. She knew that other kids knew that she was different. She was very adamant about not being singled out. I remember in school departments they will periodically send out information to parents with kids with special needs letting them know about their rights and responsibilities. She got irate when she got something at her house that said it was to the parents of so-and-so because she was being singled out. She didn't want to be singled out. She stopped going to resource help because of that. She has done well in school in spite of that. She is a hard worker. She is a smart kid. She still spells poorly. She has a tough time.

Offscreen participant:
[inaudible] about why do you think there may be a big increase-there may be a positive side, not that they have fallen through the cracks. One of the things that, I think those of us who work with women, single parents who have been on welfare especially if they have been abused and have relationships with the DSS, one of the things that was a shocking learning to a perky kid was that in a family literacy program I was working with a women was beaten up. It wasn't the first time that she had been beaten up. She came into the program in the morning so badly bruised, that if it hadn't been for the hair we wouldn't have recognized who she was physically. It was a horrible thing. She had a five-month-old son. This was the second time she had been beaten up. She was entirely a victim. When she came in and was explaining the story to the group of women there, it was as if I wasn't in the room. This whole underground culture emerged for me to see. They asked her what she did. They said, you didn't go to the hospital, did you. I'm thinking, of course you go to the hospital. They had a network. Did you tell them your right name? It was a whole system of support among these women that had created this kind of culture. They knew that by going to the hospital and giving your name, someone was going to come out. There was a chance she would lose her child as a result of that. I had an ear to this whole support culture of women who had learned how to survive in these circumstances with a lot of not good things. Things that are meant to serve them are in fact keeping them away from the services because they don't trust that good things are going to happen as a result of the service. Once that underground network is breached with trust, when they think there is a program or a person in a system that they can go to and trust, more people come out. It's the word through that grapevine that we have to infiltrate. It's hard. As characteristics, there is an underworld that is supportive. It's like a parallel universe going on that we don't necessarily have access to as service providers.

Steven Brunero:
That's true. It's also one of the reasons why we think that substance abuse is under-reported. We're still government officials or teachers. They think that if they disclose those kinds of things they could lose their children, etc. You're right. There is a subculture that exists out there.

Offscreen participant:
They support one another really well. When they are homeless, they can crash with friends. Our sense of them-it's much more rich in its dimension than when we recognize when we fill out characteristics and check them off. It's a more difficult world.

Steven Brunero:
This gal has worked in some of the urban areas in Los Angeles. She talks about that subculture that exists out there and how resourceful people are. If you can focus on some of the strengths of resourcefulness they have, whether it's a drug dealer who can maybe be an accountant some day because they can handle money. Whatever it is, you can look at some of the positive attributes of individuals. Before you can do that, you have to reach out and establish trust. People have to be able to trust that you are not going to report them because they smoked pot the night before so the local authorities will take their kids away. Developing a relationship of trust is important.

Steven Brunero:
I think a lot of it is-one of my colleagues had looked at our program. My Administrator said, what you guys are doing is not all that creative and different. You guys care about people. You are reaching out and that shows. That's what it is about.

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Transcript - Learning Disabilities Program Outcomes Based on Bridges to Practice - Rhode Island's Presentation