Karen & Jack's First Meeting
4/5/98

Jack: Hi Karen, it's very nice to meet you. I understand you want to re-open your V.R. case.

Karen: Yes.

Jack: Well, I've looked over your closed case file from your previous V.R. experience. It looks like you successfully went through the McJobs training program and began working at McDonalds. But you mentioned on the phone that that didn't work out.

Karen: Yes. At McDonalds, they only gave me about 18 hours a week, which I wanted more. And I had some problems getting along with the assistant manager because it didn't seem like he was interested in increasing my hours. I really wanted to work full time. So I quit McDonalds and began working at Hardee's, because at Hardee's I can get full time hours. So I'm still working there now. But I'm not sure I want to stay in the fast-food business. Sometimes I feel myself getting frustrated and mad from dealing with so many people. I try walking and stuff, and that helps. And I have my memory book, because I sometimes have trouble remembering things. And the book helps a lot. But I still I don't know, I just think I could find something not so frustrating.

And my Mom moved up here from Texas last year, and she heard about Medallion. So she and I think maybe they could help me find something.

Jack: Well, I've gotten permission from my supervisor to reopen your case, so let's take a look at what we need to do to get things going. You've got the application form filled out?

Karen: Yep, I have it right here.

Jack: OK. First, for eligibility, we have to determine that you have difficulty getting work and that it's something that VR can help with - that you are eligible. From the previous case documents, and from what you've told me, there is definitely an impediment for your work from the disability. You're working full time right now, so technically you already have a job, but that may not be a problem depending on your income. Which you've got here as . $180 a week. Let's see how that compares to the eligibility limits.

I'll need to look that up here in the Policy and Procedures Manual - it's kind of like our rule book on VR policies for the State. And looking in the PPM index, we find.. nothing. Where is the list of salaries in here? OK, single, living on your own. The limit is $1,286 per month, so there's no problem getting you eligible even though you're working full time. I didn't think there would be, but we always have to check.

All right, we'll need to document all of this, so we'll need to start filling in this Cost Worksheet. Did you do one of these for Jackie last year?

Karen: No I don't think so. I don't remember.

Jack: Well, this is kind of an official planner that documents how much money you are making, what other grants or help might be available, and how much VR is going to contribute to whatever services we decide on. So we'll start filling this in as we go. And I'll work on filling in most of the things on the Financial Application and the Cost Worksheet later on, so we don't need to take time on that now.

Let's take a look at the previous eligibility form. Now, your previous eligibility statement, the one you and Jackie drew up, talks about some memory problems and some trouble with emotions. Would you say that is still going on?

Karen: Uh-huh. Ever since my accident when I was 14, I can't remember things as well. It's like I can't keep track of everything. And sometimes I get real angry, still, about things. Later I can see they are little things, things people didn't mean to do, but at the time - boy, do I get mad. I think I'm better about knowing when it's happening and trying to do something about it, but. Like the other day, Tina, at work, she wouldn't let me do any of the prep work. And I couldn't figure out why. She would let me clean the dining area or make fries, but that was all. So finally I asked how come, and she just wouldn't tell me. She said, "Well, I just think you enjoy the dining area better." And I got so mad. I went for a long walk after work and calmed myself down. In the past I probably would have snapped at her later on, but now I can calm myself down better.

Jack: So I'd say these are still good reasons for you to want some support from VR - difficulty with your temper and forgetfulness, right?

Karen: Yes.

Jack: Now, we also have this health assessment questionnaire that I need you to fill out when we get done. From your file, it looks like you had a psych eval last year when you and Jackie were doing your eligibility, is that right?

Karen: Yes.

Jack: So I don't know see any reason to do another one. However has anyone examined you to check on the status of your seizure disorder since let's see, that original examination was back in Texas in '91, with a follow up in '92. Has anyone taken a look at that since then? At the seizure disorder?

Karen: Well, I see Dr. Waggoner, he's my regular doctor in Clayton, and he gives me the prescription for Tegretol.

Jack: But there hasn't been, like, a neurologist or anybody that has checked you lately?

Karen: No.

Jack: Well, let's have that done. We've worked with Dr. Evans down in Clayton before, so why don't I have my secretary schedule you with him. We'll check on that when we are done, and I'll go ahead and authorize it so VR will pay for the exam. That will help us confirm it as a minor disorder.

So that should take care of the paperwork to re-open the case and get you moving through the VR process again. Let's talk some about Medallion. What do you know about them?

Karen: My Mom talked to her friend Eddis, who knew someone who used to work there. And she said that they help train lots of people with disabilities and help them with job hunting skills and things. She said there are lots of different, real jobs they could train me for, not just more McJobs skills.

I know I can keep working in fast food, if I want to, but I keep having trouble making enough money and getting enough hours. Plus, I have to keep myself focused on paying attention to everything when I have to deal with so many people. To get something right, I have to concentrate and practice, but as long as I get a routine down, and use my memory book and experience fewer surprises - things go better. Right now, I'm working at Hardee's. And I write down everything I have to do like the ham and turkey melt instructions. I tend to go into great detail, because that what it takes for me.

Jack: What would you rather be doing?

Karen: Well, something with a better routine. I used to think about being a secretary or maybe a book keeper, so I was kind of thinking about that. At one time I was going to try being a travel agent, but. I don't remember why we didn't do that. It's got to be something that is close to my house, though, so I can walk, because I can't drive.

But I can walk a long way, if I have to. The other day my aunt had asked me to go get her some more oatmeal, because she was going to cook something. And she meant for me to go down to the corner to the Quick Kitchen, but I didn't know they had oatmeal there, so I went all they way down to the Shop-N-Go, which is about a mile from the house. I didn't think anything of it, it was just a walk. But she said she was wondering what took so long when I got back, which made me kind of mad. I mean, how was I supposed to know the Quick Kitchen would have that? So then I went out and walked some more until I calmed down.

Jack: So you can really walk! That's great. Getting back to Medallion, let me tell you a little about what sorts of things they can do. They are a community rehabilitation program here. There are about 80 people that work there full time, and they typically train more than 300 people with disabilities each year. There are certain types of jobs that they specialize in, such as clerical, retail sales, and laboratory technician, but they can also train for basic skills in a lot of other jobs. We've had a number of people go through their program over the years, and do quite well. So I think you're right, they can probably help us find something better for you.

Community Rehabilitation Program - a program that provides (or helps provide) rehabilitation services. A CRP is not necessarily housed in a specific building or place; it may be distributed through several coordinated offices. In the past, these were called "rehabilitation facilities", but the name was changed to include more distributed programs that aren't located in one central building. Goodwill, EasterSeals, and McJobs are CRPs with an emphasis on job training.

First, however, we are going to need to figure out some specific jobs that might work for you, and there are several ways we could do that. Sometimes we do "job shadowing", which is where we find someone who already works doing what you think you want to do, and have you follow them through their day, maybe help out for a while. Or there is "situational assessment", where we arrange for you to actually try some jobs out for a day or so. Or we could have you interview - talk to someone who does that job. But those work better for people who have stronger idea about what they want to do, and I don't get the feeling you are very sure yet, right?

Karen: Right.

Jack: Another possibility we sometimes use is one of the vocational interest inventories, where we have you answer some questions about your interests and match those up with the interests of people in various professions. But we also need to look at some aptitude and academic abilities for you. For all of that, we can also use Medallion. They do vocational assessment for people to take a look at someone's strengths and weaknesses, and their interests as well. I think that might be our best first step. Have you ever had a vocational assessment?

Karen: No. I don't think so. They tested me a little, back in Texas, when I first went to Goodwill, but I don't remember the results.

Jack: Hmm. I don't have any description of that in your case file either. So let's go ahead and schedule you for an assessment at Medallion. Now, the assessment is going to take... I think it is four weeks to do a full evaluation. Is that going to cause any problems for you?

Karen: I guess I'll need to leave my job at Hardee's. I haven't told my manager about this yet, but I'll need to.

Jack: Yes. But if you are going to get training for a new job, you'll need to do that anyway. Is that a problem?

Karen: No, I was starting to wonder if I was going to have trouble getting enough hours there anyway. I mean, Mitchell is nice, much nicer than Ray ever was, but, like, last week, I only had 20 hours scheduled for me when I was expecting 30 like I had the week before. And that got me frustrated.

Jack: So you will go ahead and quit Hardee's? Why don't we go ahead and schedule that for you for next month, for May. That would be about four weeks from now, which should give you time to see Dr. Evans about the seizures and settle things at Hardee's. I'll get ahold of Martha Little at Medallion and arrange that for you and let you know for certain, but I don't expect there will be any problem. Do you have any place to stay in University City for that month? Any relatives?

Karen: No. I don't know how I'd pay for an apartment if I'm not working

Jack: That's OK. We can work something out. Medallion has rooms for people who are there for training or are there for assessment, so we will just get you one of those. I'll go ahead and get the authorization on all of this so that VR can pay for it. Once we've got the assessment results, we can meet again to talk about what training you might need and what sort of job prospects it will give you in this area of the State. Does that sound OK?

Karen: Yes. Let me write this down in my book.

Jack: OK. You are going to schedule with my secretary for an appointment with Dr. Evans sometime in the next couple of weeks. You are also going to finish up the health assessment form before you leave today. I am going to schedule you for a 4 week assessment in May, and I'll let you know the exact dates on that. You are going to need to tell your manager at Hardee's that you will be quitting at the end of this month.

Meanwhile, I will get the rest of these VR forms filled out - the new eligibility form and the authorizations for VR to pay for your visit to Dr. Evans and for your assessment, plus living expenses while you are at Medallion.

When the assessment is done, you and I will meet again and discuss the results, and we'll start a new IWRP then. Does that sound OK?

Karen: Yes

Jack: Are you going to have a way to travel to Medallion from Clayton? Can your mother bring you or something?

Karen: Oh sure, I don't think there will be a problem.

Jack: Well, Karen, unless you have any questions, I think that is all we need to do today. It was good to meet you again. Feel free to call me if anything comes up or if we need to change anything. Ok?

Karen: OK. Good bye.

Jack: Good bye.

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Name of Client: Karen Spencer
Address: 408 Box St., Clayton, MO
Person(s) contacted: Jack Greene
Contact made: [] Home [X] Office [] Phone [X] Personal [] Other
Date: 4/5/98

Purpose: Initial Interview

Action Taken:

Karen presented by herself. She is a client I had met before at the Clayton McJobs when she was Jackie's client. I have received her closed case file and gone over it with her. After discussion, it was determined that Karen would be best off at Medallion, but we will need some initial voc eval from them before an training. She expressed an interest in accounting and bookkeeping. I think they probably have a secretarial skills program that would suit her needs. She is quite nice and pleasant.

Next Action:

Open the case. Review closed case file more thoroughly, probably check with Jackie Crawford to get her opinions and impressions of Karen. Fill in Eligibility Form and Financial Application. Contact Martha Little at Medallion to schedule an assessment for Karen. Confirm that Jesse has made an appointment for her with Dr. Evans.

Signature: Jack Greene
Date: 4/5/98

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