VCU 
6/20/05
1:00 PM CT
WEBCAST - PAS
Presenter: Louis Orslene
Captioning Provided By: Caption First, Inc.
    
     
    >> LOUIS ORSLENE: Good afternoon, everyone.  My name is 
Lou Orslene, from the International Center for Disability 
Information based at West Virginia University.  I come to 
you today to talk a little bit about personal assistance 
services in the workplace.  Today's presentation is 
entitled "Making PAS Work for Your Clients."
    The objectives today that we hope to accomplish are:  
Know about the Center for PAS and its mission.  Understand 
what personal assistance services are.  Know the 
distinction between PAS for job tasks and PAS needed for 
personal care in the workplace.  Know a little bit about 
the historic and current funding mechanisms for PAS.  Know 
the current state of PAS in the workplace.  And know what 
resources exist for learning more about PAS.
    Let's begin by talking about the Center for Personal 
Assistance Services in California.
    It's based at San Francisco, funded in 2003, has a 
five-year program grant from the National Institute on 
Disability and Rehabilitation Research.  The Center for PAS 
team includes the Topeka independent living resource 
center, info use, the para-professional healthcare 
institute, the Institute for the Future of aging services, 
and faculty at the University of Maryland, University of 
Michigan, and West Virginia University's Job Accommodation 
Network.  The center's activity is also steered by a blue 
ribbon advisory panel of PAS users, disability advocates, 
business leaders, independent living center leaders, and 
academics, who provide guidance to the project.
    The mission of the center is to provide research, 
training, dissemination, and technical assistance on the 
issues of personal assistance services in the workplace.  
The center fulfills its goal by providing research, 
training and dissemination on informal and formal PAS, PAS 
in the home and the community, PAS workforce and workplace 
PAS.
    The outcomes that we hope to achieve in terms of 
workplace PAS are:  Establishing a baseline of PAS in the 
workplace; and identify and disseminate best practices for 
PAS in the workplace in order to facilitate the employment 
of people with disabilities.
    We are doing this research by interviews, surveys, and 
focus groups with employers, employees, and people with 
disabilities and also rehabilitation professionals.  The 
workplace PAS component of the Center for PAS is being 
headed up by an organization called Info Use in Berkeley, 
California, with its principals, Susan Stoddard and Louis 
Krause.
    Let's talk about exactly what personal assistance 
services are.  Personal assistance services refer to help 
provided to people with disabilities to assist them with 
tasks essential for daily living, and this is the 
definition -- the working definition that we use at the 
center of PAS.  Just to let you know that the tasks of 
daily living include bathing, dressing, getting around, 
toileting, shopping, remembering things, and other 
activities.
    I'll also offer you another definition.  This definition 
is from the Ticket To Work and work incentives program.  
PAS is defined there as a range of services provided by one 
or more persons designed to assist an individual with a 
disability to perform daily living activities on or off the 
job.  That the individual would typically perform without 
assistance if the individual did not have a disability.  I 
use this definition. I think it's important because it's 
important for you to know that personal assistance services 
are person-to-person services.  PAS, along with assistive 
technology such as wheelchairs, text readers, hearing aids, 
help people with disabilities to participate in 
activities at home, at work, and in the community.  In 
that sense, assistive technology complements PAS in the 
workplace.  Assistive technology is not, in itself, 
personal assistive services, which are, again, person to 
person.
    What are workplace PAS?  Workplace PAS include 
work-related task assistance and some of the examples that 
I offer here and have been offered by others are readers, 
interpreters, help with lifting and reaching, reassignment 
of nonessential duties to coworkers, et cetera.  The second 
type of workplace PAS is workplace personal care related.  
This is helping someone to access the restroom, to help 
someone eat or drink while they're at work.  It's very 
important to draw the distinction between work tasks and 
personal care-related PAS for one primary reason.  In a 
word, funding.  Often the type of PAS to be used dictates 
the sources of financial support you'll need to explore for 
your client.  For instance, understanding the intersection 
of work task related PAS and the potential employer's 
ADA. obligation will help you to begin patching together 
the funding necessary for your client's PAS.  Thus far in 
our research with employers, we find that the primary 
source of financial support for workplace in the workplace 
PAS is the employer. We'll talk a little bit later more 
about the ADA. and the employer obligation.
    More language that's important for you to understand is 
that of formal and informal PAS.  It's a simple distinction 
but it's an important one.  Knowing the language of PAS 
when assisting your client enables you to successfully 
structure the PAS arrangement.  
First of all, formal PAS is provided by a person who is 
paid.  As simple as that.  Informal PAS is provided by a 
family member, friend, volunteer, and it's just important 
that the person who is assisting the employee is not paid.
    In our research thus far, 
we've found that people with disabilities patch together 
the help they need in their lives, both with unpaid and 
paid help.
    I just wanted to sort of quiz folks out there, and 
see if you are getting these subtle differences 
between some of the definitions that I've offered so far.  
Let's look at which of these is not an example of 
personal assistance services in the workplace?  Weekly 
manager monitoring of an employee about workplace behavior 
expectations?  A personal assistant assisting an employee 
to dress for work?  A family member coming into the 
workplace to assist an employee with lunch?  A coworker 
filing forms for the employee?  If you were thinking 
that number two was actually not an example of PAS, you're 
correct.  A personal assistant assisting an employee to 
dress for work is not an example of workplace PAS.  This is 
actually personal care.
    Let's try it again.  Which of these 
are work task related PAS?  A coworker reading daily memos 
to the employee?  A family member, paid by the employer to 
travel with the employee on a business trip?  Community 
access realtime translation, sometimes otherwise referred 
to as C.A.R.T. being used during an employee training?  Or 
a coworker providing transportation to and from work?
    If you guessed Number 4, then you are correct.  Number 4 
is not a work related task.  That is personal care.  
Transportation is the responsibility of the employee of 
course unless the employer typically provides 
transportation for other employees.  Then it may be 
considered work-related PAS.  Otherwise, it's personal.
    Let's again look at the language.  Which of these 
are workplace personal care-related assistive services?  A 
coworker helping an employee into the restroom?  A personal 
assistant traveling with an employee to a training?  A 
family member setting up the employee's lunch area?  Or a 
personal assistant providing transportation to and from 
work?
    Again, we're talking about personal care-related instances.  
What I would tell you is if you've chosen Number 2 as 
being the outter there, then you're correct.  Number 2 is 
not a personal care-related assistance service.  A 
personal assistant traveling with an 
employee to a training is actually a work-related personal 
assistant.
    It's important for you to understand, to the extent of 
PAS usage in the workplace.  According to work trends 
restricted access, a survey of employers about people with 
disabilities and lowering barriers to work, about one out 
of seven workers with disabilities describe the need for 
accommodation, while only about one in 100 have reported 
PAS needed for work.
    [It's] very, very important to note that while a small 
percentage of workers with disabilities relate needing PAS, 
it's imperative for these workers who have the requisite 
skills, abilities, and knowledge to be productive and 
successful with their jobs. PAS is very, very important 
to even those few people that find it necessary in order to 
work.
    Who uses PAS?  It's also important for us to 
understand that.  According to Bobby Silverstein, in his 
policy brief, the applicable of the ADA. to personal 
assistive services in the workplace, he writes, "Some 
people with disabilities have functional limitations that 
may create barriers to employment.  For example, a 
quadriplegic may have the requisite education, experience 
and expertise to perform the essential functions of a job, 
but may be unable to perform nonessential job functions.  
Example, turning pages without assistance."
    In the past, when we spoke of employees using 
disabilities, often we were talking about people with 
severe disabilities that they've acquired 
early in life, but there's some changes going on in the 
workplace.  According to The Center on an Aging Society, 
PAS is a part of the accommodation spectrum. There is 
currently a growing awareness of need for PAS at work.   
We're seeing as the population ages, that the PAS support 
needed for these aging workers is also increasing.  We 
also know that PAS as a workplace accommodation is not as 
well-established as the concept of assistive technology in 
terms of the range of possible workplace accommodations.  
This is simply due to its more limited usage.
    Let's talk a little bit about the history of 
personal assistance services.  This is not a comprehensive 
history of personal assistance services, but I've tried to 
include some of the major events during its history.  This 
movement begins out of the Center for Independent Living 
movement in the 1980s.  People like Judy Heumann and Ed 
Roberts were instrumental in bringing personal assistance 
services, particularly those services within the workplace, 
into the public arena. It made people much more 
aware of them.  Of course they were based at the Berkeley 
Center for Independent Living at that time.
    In 1981, the home and community-based service, HCBC 
waiver program offered states federal matching funds to 
expand HCBS and accelerate the movement from long-term care 
provided in an institution.  This is the first movement 
that we see for people moving out of the larger 
institutions and into the community-based programs.   
From our research so far, we've spoken to a number of 
people who receive these waivers in 
the early 1980s and continue into the workplace today.
    The next event is the Americans with Disabilities Act.  
It was passed in 1990, and progressively implemented up 
until 1994, where employers with 15 or more employees are 
covered.  Next, we have the 1993 Omnibus Budget 
Reconciliation Act.  This act de-medicalized personal care 
services by eliminating the requirement that services be 
prescribed by a physician by making nurse supervision 
optional and by providing those services.  Those 
services could be provided anywhere, not just in the home.
    In 1999, the Ticket To Work Act was passed, and it 
included work incentives and encouraged states to adopt the 
option of allowing people with disabilities to purchase 
Medicaid coverage that's necessary for people to maintain 
their employment.  In 1999, also, the Supreme Court case, 
Olmstead, occurred.  In the court's Olmstead decision, the 
ADA. was upheld in the court, and the court ruled that 
unnecessary institutionalization constitutes unlawful 
discrimination under the ADA. 
    In 2003, the Center for PAS was initiated by funding from 
the National Institute on Disability and Rehabilitation 
Research. In 2005, Senator Harkin proposed the national 
Medicare Community-based Attendant Services and Support 
Act, otherwise known as MiCASSA.  He also proposed 
Money Follows the Person Act.  There's also a Bush 
administration proposal in its new freedom Medicaid 
demonstration act that is also opening up more funding 
sources for personal assistive services in the workplace.
    Once you understand the language of PAS and you're 
aware of the usage of PAS to support people with 
disabilities in their home, community, and work, then you 
need to understand how to seek and obtain the funding 
necessary to sustain your client's personal assistive 
services arrangements at work.
    Let me review the funding streams for PAS in the 
workplace, as indicated by our research so far.
    First, we find that employers are taking up the 
obligation, and they're providing much of the personal 
assistive services under the Americans with Disabilities 
Act, the ADA. 
    Second that we found out that considerable amount of 
people are being provided funding through the state 
Medicaid infrastructure grant called MIG, and that's under 
the Ticket To Work program.  Next is the state Medicare 
waiver funding.  We've also found that state VR agencies 
are direct-funding and people have line items within their 
budget and they're providing personal assistive service.  
Then lastly, we're finding that individuals with 
disabilities are supporting their own personal assistive 
services in the workplace.  What we've also found is that 
in some cases, that the state vocational rehabilitation 
agency is funding so much of the personal care services.
For instance, paying the personal assistant minimum wage, 
and then the individual with a disability brings that wage 
up to maybe eight or $9, and that increases the likelihood 
then that that person is going to stay in the job, so that 
the whole situation, the whole arrangement, is that much 
more stable.
    Let's talk for a minute about the Americans with 
Disabilities Act.  Since we found in our initial study that 
most PAS is being paid for as an accommodation under the 
ADA., let's just do a quick review.  Passed in 1990 and 
fully implemented with employers with 15 or more employers 
by 1994, the ADA. covers applicants and employers of both 
private and public employers, as long as the applicant 
meets the definition of "disability" under the ADA., and 
the person is qualified for the position.
    When these stipulations are met, then the employer may 
need to consider making reasonable accommodation to the 
known physical and mental limitations of an otherwise 
qualified applicant or employee, unless the employer can 
demonstrate that the accommodation would impose an undue 
hardship on the business.  For the purposes of the ADA., 
a qualified person with a disability is defined as someone 
who meets the skills, experience, and education and other 
job-related requirements of the position held or desired 
with or without reasonable accommodation.  They must be 
able to perform the essential functions of the job, of 
course.  It is also important to mention that there is 
recognition that while the ADA. specifically addresses 
task-related assistance on the job, some people need both 
job tasks as well as personal assistance to succeed 
in the workplace.  Many of these people, of course, have 
the requisite skills, knowledge and abilities, and they 
really do not need accommodation in terms of the 
work-related tasks.  However, they do need, for instance, 
maybe someone to come in and set up lunch for them, someone 
to help them access the restroom, and possibly someone to 
assist them in getting ready to leave for work.
    It is recognized by employers that it is very 
important that we provide and enable the provision of 
personal care-related tasks in the workplace, even for 
those that don't need work-related tasks PAS.
    To understand a little more about the integration of 
the ADA. and PAS in the workplace, often we look to the 
Equal Employment Opportunity Commission who enforces the 
provisions of the ADA.  The EEOC says in its interpretive 
guidance on Title I, the employment section of the ADA., 
that:  "Providing personal assistance such as a page-turner 
for an employee with no hands or a travel attendant to act 
as a sighted guide to assist a blind employee on an 
occasional business trip may also be a reasonable 
accommodation."
    The EEOC also suggests that it may also be a reasonable 
accommodation to permit an individual with a disability the 
opportunity to provide and utilize equipment, aids, or 
services that an employer is not required to provide as a 
reasonable accommodation.
   I include this, again, just to make the 
point that many people do not need accommodation for their 
work-related tasks but they may need personal care in order 
for them to maintain and be productive in the workplace.  
The EEOC certainly stands by that.
    Let me offer a few workplace accommodation examples, 
and these are taken from the Job Accommodation Network.
    One is a law firm trained an existing legal secretary to 
read handwritten correspondence to a contract attorney who 
is blind and had no difficulty accessing text material when 
using the screen reading technology, but could not read 
handwritten correspondence.
    Another example from JAN is an employer who provided a 
travel assistant to be a sighted guide for an account 
executive based in New York City.  The person is legally 
blind, and they're required to attend work-related training 
in San Francisco.
    One more example.  A school district arranged for a 
coworker teaching in the same department to serve as a 
mentor for a newly hired geography teacher with bipolar 
disorder who had difficulty developing her work routine and 
at times exhibited inappropriate work behavior.  Together, 
the teacher and her coworker/mentor review time and stress 
management techniques, discuss appropriate work behaviors, 
and develop strategy for adjusting to change.
    Those are some of the examples that we've pulled from 
actual cases of the Job Accommodation Network, just to make 
you aware of how this is really working in the workplace.
    From the ADA, let's talk a little bit about the MIG 
grants.  Besides the employer-funded PAS in the workplace 
under the ADA, relatively new legislation has been put 
in place that increases grant funding.  One such law is the 
Ticket To Work Incentives Improvement Act of 1999.  The 
Medicaid infrastructure grants, otherwise known as MIGs 
were funded as part of the Ticket To Work program.  They're 
administered through the U.S. Department of Health and 
Human Services and overseen by the Centers for 
Medicare and Medicaid Services.  This grant program is 
specifically designed to provide grants to states in order 
to support people with disabilities that want to go to 
work.  The distinct purpose of these grants is to increase 
the number of people with disabilities in competitive 
employment.
    To better understand what's happening and where, the 
centers for Medicare and Medicaid have designed an 
interactive web page so that you'd be able to find out 
what's happening on this issue in your state.  If you look 
at the map in front of you, if you go to the centers for 
Medicare and Medicaid website, this page is interactive.  
The states in blue have been awarded personal assistance 
services demonstration grants.  The states in green have 
been awarded infrastructure grants.  The states in red 
have been awarded both demonstration and infrastructure 
grants.
    To find out information, contact information for these 
programs, simply go to the site and click on your state.
    Another funding source that we heard a lot about during 
our research are the state plans or the state waiver 
programs. We know that many states continue to analyze 
whether and to what extent PAS should be provided to 
individuals in the workplace under Medicaid either as a 
benefit under the state plan or as a service provided under 
a federal waiver.
    Again, the center for Medicare and Medicaid services is 
very helpful, so that we can see what is happening and 
where.  If you visit the center's website, you can also 
find the state waiver programs and the demonstration 
programs.  Again, simply by clicking on the state, you can 
see the name of the state waiver or demonstration program, 
and you can find the contact information.  This enables 
you to go directly to the source and directly to the 
program to find out what's happening with those waivers and 
possibly if your client is eligible.
    Another source that we've heard of during our interviews 
and during our surveys has to do with the funding by state 
vocational rehabilitation programs.  We found out that many 
of the states have built people and their PAS services 
directly into the state VR budget.  Some of these PAS 
situations date back to the demonstration programs of the 
early 1980s.  State vocational rehabilitation may 
support the PAS arrangement directly or serve to conduct 
the assessment for PAS and maintain the waiting lists for 
other programs.
    They're an important contact for you. They're an 
important resource as well.  From the preliminary research 
that we've done with employers, rehab professionals, and 
people with disabilities, we find that workplace PAS is 
most often patched together by the employees in order to 
maintain their employment.  We hear that workplace PAS is 
not only patched together in 
terms of funding, but also in terms of formal paid and 
informal PAS.  We've heard, for instance, from people whose 
coworkers help to get off their coat in the morning.  Then 
a paid personal assistant comes in to set up for lunch, and 
then a coworker assists with the person going to 
the restroom, or a family member comes in.  Then again, 
at the end of the day, a coworker would help to put the 
person's coat on and help them to get to the transportation 
in order to get home.
    Let's quickly recap how people are patching together 
their PAS arrangements.  Again, we've talked about 
employers under the ADA.  From our experience, most PAS 
at this point is being provided under the Americans with 
Disabilities Act.  Also, the MIG grants, the Medicaid 
infrastructure grants under the Ticket To Work.  Then the 
waiver programs.  State VR.  Then the employee needing 
PAS often subsidized or supplemented a certain amount of 
money that's coming in from other sources.  Also, don't 
forget informal PAS as well.  All of these combine to make 
a more productive employee and a successful workplace 
personal assistive services arrangement.
    In addition to all of the legislation that's occurred 
since the 1980s, there was a Supreme Court decision that 
impacted personal assistive services in the workplace and 
that's the Olmstead decision.  Implementation and 
compliance with Olmstead means promoting community 
integration over institutionalization and rebalancing 
long-term services and supports.
    With the Olmstead decision, the U.S. Supreme Court upheld 
the ADA. and ruled that unnecessary institutionalization 
constitutes unlawful discrimination under the ADA.  
Further the court said that as long as the individual 
agrees, treatment and personal supports and services of an 
individual with a disability must be conducted in a home or 
community setting over an institution, which is deemed 
appropriate and of equal or less cost.
    In addition to all of the legislation, we're also 
having pressure on the states from the Supreme Court to 
rebalance between long-term care in institutions, 
the community, the home, and the workplace.
    In some of the research that we've done so far, we 
wanted to see where exactly the PAS was occurring.  Of 
course we looked at the center for Medicare and Medicaid 
website and looked at where the demonstration projects are 
going.  But we also looked into some of the 
vocational rehabilitation agency data, and we looked at it 
from 2002, 2003, and 2004. We looked at the states with 
the highest usage.  You'll see in front of you that 
these are the states.  If you're someone who is just 
picking up the language of the personal 
assistance services, you're just coming to grip the  
the funding streams, and you identify that one of your 
states is on this list. There's certainly a 
a high likelihood of you being able to 
contact someone there. Find out if you can patch 
together some funding mechanisms in order to get your 
client personal assistance services they need in order to 
be in competitive employment.
    There's also new legislation.  Of course this 
legislation has been written a number of times over the 
year.  However, what you see in front of you on this slide, 
MiCASSA and money follows the person. These have been 
reintroduced in 2005.  These legislative acts have been 
introduced by Senator Harkin and a number of other people 
have come on and are supporters of this legislation.  
Again, the intent of this legislation is to rebalance the 
long-term care of citizens with disabilities from 
institutional care model to more of a home-based and 
community-based model.
    MiCASSA gives individuals who are currently eligible for 
nursing home services and institutional facilities equal 
access to community-based attendant care services and 
supports.  The legislation also provides for additional 
funding to states to help them reform their long-term care 
systems and increase the provision of home and 
community-based services.  Of course that would include 
workplace PAS.  Further, MiCASSA establishes a national 
program of community-based attendant care services and 
supports for people with disabilities. This is very 
important because as we've heard in the many interviews 
that we've done, that a clearinghouse, a central 
information source, is very necessary for people to 
understand all of the various things that they need to 
understand in order to patch these mechanisms together and 
patch this personal assistance services together for both 
home but also, in particular, for the workplace, 
which PAS is a little less known and is a little more recent 
innovation.
    Senator Tom Harkin from Iowa also introduced 
legislation called Money Follows the Person Act of 2005.  
This legislation would let Medicare money follow the person 
with a disability from institution into the community.  
It would provide a hundred percent federal reimbursement for 
all community services to individuals and their needs during 
the first year out of institution in nursing homes.
    What I've been trying to convey to you is everything 
that you need to know in order to provide those personal 
assistance services to your client, to make them much more 
likely to succeed in their employment placement at their 
job.  Let's again look at these things.
    What do I think you need to know in order to move 
forward, along with your client or consumer?
    First of all, I think you need to know the language of 
PAS.  Informal, formal, personal care related, PAS related.  
I think that's very, very important.
    Also know where to seek technical assistance concerning 
ADA. and where the ADA. intersects with PAS.  That's 
very important.
    Also, know where to locate information about what PAS 
situations work and what doesn't.
    Know who to contact regarding your state's programs.
    Lastly, watch for legislative action.  That's very 
important, because if we see the passage of MiCASSA and 
Money Follows the Person in 2005, then that's going to open 
up a whole new funding stream, and a clearinghouse.   
It's going to organize all of this somewhat better, to make 
it more accessible to you, more accessible to the person 
with a disability who wants to become employed. That 
could only be better for all of us.
    In terms of PAS resources, the one that I would 
suggest is the Job Accommodation Network.  They provide 
practical PAS suggestions and they can also talk you 
through that ADA/PAS intersection.  Also I'd suggest 
using the Center for PAS website.  They have best and 
promising practices.  Also, there's a Virginia Commonwealth 
University-produced consumer-directed guide to PAS.  
Lastly, subscribe to Steve Gold's listserv to keep abreast 
of changes on the national front.
    The Job Accommodation Network, while their website 
is an excellent source of information, if you really need 
one-to-one technical assistance to walk you through the 
process of providing PAS, then I'd suggest that you'd call 
their national toll-free 800 number.  But on the website, 
if you go into their media and you scroll down through the 
page, you'll see that there's a personal assistive services 
in the workplace document. This document details the 
practical to-dos of developing PAS situations.  This can 
be very helpful in enabling you to understand, for your 
particular client, how you can pool all of these things 
you need to, in order to create a successful PAS arrangement.
    Again, if you want to see what is happening out in the 
country, you want to see the successes and you want to 
understand what it takes in order to be successful in 
arranging PAS, then you want to use the Center for Personal 
Assistance Services website.  If you go to the home page, 
you click on the first heading on the 
left-hand side of the site.  It's called  
"State Information."  There you'll find contact information for 
those who are responsible to administer your state's 
Medicare waivers and such.  You have two places to go.  
You can either go to the center for Medicare and Medicaid, 
or you can go to the center for personal assistive services 
and look at their -- under their state information and that 
way, you'll have that contact information.  You'll be able 
to find out what's working in your state, how it's working, 
how it's funded, and what you need to do to get your clients
on that waiting list or into using personal assistive services.
    The Virginia Commonwealth University puts out an 
excellent consumer-directed guide.  This guide provides 
good practical information about recruiting, hiring, and 
training a personal assistant.  It also provides a sample 
contract form between the personal assistant and the person 
with a disability.  Again, note that it's consumer 
directed guide.  While you're the support person, you're 
the employment person, facilitating the arrangement of 
personal assistive services, that your client, your 
consumer, should be involved in every aspect of this 
arrangement, and really what you should be doing is getting 
them the tools they need in order to recruit and  
and hire a personal assistant, and for that contract 
to be drawn up between them.  
Also, of course, I should mention the training as well.  
Only the person with a disability is going to know what the 
level of support is that they need or don't need in the 
workplace. It's absolutely imperative that 
this process be designed in such a way that it really be 
consumer directed.  What I would refer you again is to 
this VCU document, which will walk you through the process, 
give both you and your client the information you need to 
move to the next step.
    What I'd also give you is a resource.  Steve Gold is 
a Philadelphia lawyer and advocate for people with 
disabilities, and I'm part of the listserv 
that he generates. This, too, I think, is a great 
resource for people.  If you go to this website, you enlist 
in their listserv, then any new developments, whether it be 
MiCASSA, money follows the person, or any other changes 
that are bubbling up in this field, you'll be able to find 
through Steve Gold's listserv.
    Lastly, a lot of times your first step may be you'll 
pull this information off the website.  There's a 
lot of information that you'll need to go through and to 
understand, but if you have questions and you really want 
to talk to a person and you really want to go and see how 
it's working, then the local resource that I would suggest 
is your local Center for Independent Living.  There's a 
national project in Houston.  It's the utilization project 
for the Centers for Independent Living.  You can go to 
their website. You can find the state 
chapters.  Then you can call them and they'll put you 
in touch with the local Center for Independent Living.  
[It's] very, very important that you have somebody in your 
community that you can talk to, that you can see it 
happening. That gives you a lot more faith and a lot 
more of the ability to see how this exactly works.
    Well, thank you very much for your participation in 
today's webcast regarding personal assistance services, and 
particularly those services in the workplace.  I hope that 
the information I shared with you today better prepares you 
for helping the people you assist in finding and 
maintaining their employment.  I also want to thank the 
TTAP program for enabling me to share this information with 
you today.  Thanks again.  
    
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