Expanding rehabilitation services to meet the legal needs of aging Americans. (Legal Issues in Aging).

As one moves from adulthood into old age, a myriad of transitions must be made. On the positive side, many people either retire from work or begin to significantly reduce the amount of time spent in employment activities. Some will downsize their place of residence by purchasing a smaller home, moving into a retirement community or in some instances, moving in with their children. Others may begin a second career, perhaps turning a hobby into a profit making business, and still others may be financially secure enough to travel, purchase their dream home or return to school.

For some, however, the transition into old age will be filled with concerns regarding healthcare maintenance, financial instability, health and life insurance coverage, and long-term care needs. The majority of adults facing these concerns will do so as a result of the ill effects of the aging process, physical/mental illness, or disability that has impacted or will impact their ability to perform a major life function, such as self care or other activities of daily living sorely compromising their independence. In these instances, the person with the disability and/or his family will be faced with a host of choices regarding future care and well being. Fortunately legal vehicles are available, and in some instances necessary, to assist in decision-making, healthcare planning, and resource management of the affected individual.

This article examines ways in which rehabilitation counselors in private and forensic practices are meeting the needs of aging Americans. Although work with aging clients in legal venues is an area of rehabilitation practice that has been emerging for some time, it remains unfamiliar to a large portion of the rehabilitation community. Consequently, an explanation of the legal terms and concepts discussed throughout this article will be provided to help further the reader's understanding of these complex issues.

Definition of Terms

Grantor--the person signing a power of attorney or other legal document which gives power or authority to another.

Grantee--the person that would exercise the powers or authority given by the grantor.

Power of Attorney--a document which gives a person the right to make binding decisions for another, as an agent. A power of attorney may be specific, applying to a certain type of decision; or general, in that the agent makes all major decisions.

Durable Power of Attorney--a type of power of attorney that is often limited in the kinds of powers that can be assigned. Unlike an ordinary power of attorney, durable powers can survive for long periods of time and can continue after incompetency is established.

Healthcare Power of Attorney/Healthcare Surrogate--a document that allows someone to make medical decisions for another person if they cannot make them for themselves. This person has broad power to act on another's behalf, including the right to make decisions regarding life-support.

Pooled Trust--a trust fund that contains the assets of disabled individuals and is established and managed by a non-profit association. Separate accounts must be maintained for each trust beneficiary, although these accounts may be pooled for purposes of managing and investing the trust funds. The funds are solely for the individuals' health, welfare and benefit (The Florida Pooled Trust, 1999).

Special Needs Trust, aka Payback Trust--is an irrevocable trust with the following requirements: (1) must be funded with assets of the individual; (2) the individual must be under 65 years of age at the time the trust is funded; (3) the individual must be disabled; (4) the trust must be established by a parent, grandparent or legal guardian of the individual; (5) any state which paid medical assistance on behalf of the individual must be reimbursed from any funds remaining in the trust upon the death of the individual; and (6) reimbursement must be up to an amount equal to the total medical assistance paid on behalf of the individual. Special Needs Trusts are extremely complex and involve sophisticated issues relating to trust law, public benefits law and tax law.

A Question of Competence

In order to make sound decisions about future care, one must be given adequate information. The essential elements of informed choice are quite applicable when discussing the array of decisions facing aging Americans in general and those with disabilities in particular. According to Corey, Corey, and Callanan (1993) there are three primary elements of informed choice: capacity, comprehension, and voluntariness. In order to make sound, knowledge based decisions, one must have the mental capacity to fully understand the parameters surrounding the issue. Once capacity is established, sufficient information about the issue must be delivered in a comprehensible manner. Finally, the individual must be permitted to make the decision in the absence of coercion or other potentially pejorative influences. In the case of many aging Americans, one or all of these elements could easily be compromised. All too often, poor decisions regarding future care are the result of emotional reactions, conflicting personal agendas, or ignorance, indicating a need for professional involvement during the decision-making process. This need represents a growing opportunity for rehabilitation counselors to be major partners in determining future health care issues facing aging Americans. The information presented in this article focuses on the civil competencies needed to make decisions about fundamental human rights and guardianship.

Competence

The laws addressing competency are extremely complex and deal with a wide array of situations. For example, there are laws addressing competency in the criminal process (e.g., competency to stand trial, to consent to search or seizure, to refuse council) as well as laws addressing civil competencies (Melton, Petrila, Poythress & Slobgin, 1997). The definition of competency differs depending on the context, and stresses that the question of competency is task-specific. For example, one may be competent to choose friends or decide how to vote but not competent to manage money, drive a vehicle or initiate a lawsuit.

When an individual is competent and able to participate in decisions regarding his welfare, legal mechanisms exist to assist in future planning. One such mechanism is a Power of Attorney (POA) which is written by a grantor, generally through an attorney, and gives a grantee the authority to carry out designated duties. The more expanded Durable Power of Attorney (DPOA) is put into place the same way, but gives the grantee expanded authority to make decisions for another person in case planning and resource management. A Healthcare Surrogate (HCS), or Healthcare Power of Attorney (HPOA), can be used to assign healthcare decisions to a grantee in the event a grantor becomes temporarily or permanently incompetent. In some instances the HCS may include the provision of a living will that can give guidance to the grantee if the grantor becomes unable to make certain decisions, such as whether or not to resuscitate in case of terminal illness or injury. All of these options require the competency of the grantor and can be easily revoked. In combination, they can provide guidance for decision making, healthcare planning and resource management of a grantor if established prior to incompetency.

Guardianship

Guardianship refers to the delegation, by the state, of authority over an individual's person or estate to another party (Rausch, 1998). Guardianship comes in many forms. For example there can be a guardian over one's person (with authority over health care decisions) and a guardian over one's property (with the authority over contracts to sell one's property) (Melton et al., 1997). Guardian powers can come with limitations such that a guardian may have the authority to oversee only one area of a person's life. Consequently, limited guardianship is most preferred as it represents the least restrictive form of guardianship.

Within the state of Florida, a determination of competency can be initiated by a petition filed by an interested person requesting an evaluation and the appointment of a guardian. Ideally, the petitioner and the requested guardian should not be the same person as there can be the perception of a conflict of interest. The Court then appoints an examining committee usually made up of someone possessing a medical license, a community-at-large member, and someone with expertise in the area in question. An examination is ordered and a process is served on the alleged incompetent person requiring them to submit to the examination. The examination includes an evaluation of the person's medical history, mental health status, and functional assessments. This evaluation results in a report which addresses diagnosis, prognosis, recommended course of treatment, and an assessment of the person's ability to retain rights. The rights to testify, present evidence, call or confront witnesses or to remain silent at the hearing are addressed individually and removed or retained at the discretion of the Court. In some cases, such as with catastrophic injury from which a major recovery can be anticipated, a limited period of guardianship is required. In other instances, such as with progressive illness or the affects of aging, guardianship can be anticipated to remain in effect of life.

Once an individual has been determined incompetent to attend to one or more personal or property areas, a guardian is immediately appointed. The appointed guardian is required to complete an application to the Court which solicits basic personal information, mental and physical status, legal history including criminal or bankruptcy, relationship to the alleged incompetent person, educational and employment history, qualifications to serve as guardian, and personal references. Guardians have historically been family members, however, professional guardians are increasingly being used by the courts and by families. Professional guardians are trained in guardianship issues, are better prepared to make objective decisions, and are less inclined to abuse their oversight authority.

Most rights removed by the court are immediately transferred to the guardian. These may include the right to sue and defend lawsuits, apply for government benefits, manage property and to make any gift or disposition of property, determine residence, make decisions about their social environment or other social aspects of life, and consent to medical treatment. However, it is important to note that even when determined incompetent, the individual retains certain rights. According to Rausch (1998) these generally include the right to: (1) an annual review of the guardianship; (2) continued review of the need for restriction of rights; (3) have capacity restored at the earliest possible time; (4) receive humane treatment with dignity and respect along with protection against abuse and neglect; (5) have a qualified guardian; (6) remain as independent as possible; (7) be properly educated; (8) receive prudent financial management; (9) receive necessary services and rehabilitation; (10) privacy; (11) freedom from discrimination because of the incapacity; (12) access to the courts and counsel; (13) receive visitors and communicate with others; and (14) receive notice of all proceedings. Moreover, certain rights may be removed from a person but not delegated to a guardian, such as the right to marry, drive, travel, seek or retain employment.

In some instances and in some venues, the law allows for an interested petitioner to ask the Court for the appointment of a guardian advocate. If clearly established and granted, this petition spells out the need for the appointment and specifically defines the areas in which assistance is required. The granting of a guardian advocate carries no presumption of incompetence and no rights are legally removed. This appointment can be requested as an alternative to a petition to establish incompetency, especially in cases of developmental disability or mild traumatic brain injury.

Rehabilitation and mental health counselors are uniquely qualified to serve as guardians. Counselors are trained to work jointly with the client in developing and implementing individualized rehabilitation and treatment plans that contain realistic, mutually agreed upon goals which are consistent with the abilities and circumstances of clients. Additionally the Code of Ethics for Rehabilitation Counselors (2002) addresses the issue of decision-making when the client's ability to participate is diminished. Consequently, rehabilitation counselors have been trained to respect the autonomy of the client when actions such as involuntary commitment or initiation of guardianship are taken, diminishing client autonomy. They are also well qualified to sit on examining committees to review competency.

Healthcare and Resource Management

Healthcare planning and resource management are two fundamental areas that must be addressed when working with an aging population. Current practices in rehabilitation counseling that can assist in providing for healthcare planning and resource management include life care planning, disability management and case management services. Life care plans originated out of a branch of Medicaid and catastrophic case management services as a means to determine damages in civil litigation cases (Rubin & Roessler, 2001). Life care plans are typically written for people who have had catastrophic injuries or chronic, debilitating illnesses. According to Rubin and Roessler (2001), life care plans have two primary objectives: "(1) to communicate in a systematic manner all the intricate details involved in a catastrophic injury case from the day of evaluation through the projected end of the client's life; and (2) to provide a format for the client's family" (p. 485).

Disability management services can be used to assist in addressing the healthcare planning and resource management needs of aging populations. Disability management is a concept typically associated with an employment setting and refers to the use of people, services and materials to minimize the impact and cost of disability to employers and employees (Schwartz, Watson, Galvin, & Lipoff, 1989). It also can refer to strategies in the workplace that seek to prevent disability from occurring or to intervene early following the on-set of a disability (Akabas, Gates, & Galvin, 1992). The primary emphasis of disability management when applied in the employment setting is prevention or minimizing the impact of the disability on the employer and employee and to assisting in job retention for the disabled/injured worker. However, as practiced by professionals assisting aging Americans with legal concerns, disability management refers to a "collaborative process that utilizes assessment, planning, implementation, communication, coordination, and evaluation in the provision of preventive and remedial services to minimize the impact and coast of disability, to enhance productivity, and to promote maximum recovery and function" (Goodwin, Taylor, Chan & Currier, p. 231). Clearly, in this context disability management represents a comprehensive set of skills and services (including case management) which are necessary to effectively address the healthcare planning and resource management need of an aging population.

Utilization of a life care plan or disability management services can provide a foundation and direction for the initial guardianship plan and subsequent annual reports. The guardian must develop and file an initial care plan, which is reviewed by the Court. This plan must address: (1) where the individual will reside; (2) the reason(s) for the selection of the particular residential setting; (3) a course of action for ensuring that the individual's residential setting will continue to be appropriate; and (4) a schedule for any medical or mental health treatment. The guardian is also required to identify those activities that the individual will be exposed to in order to increase his mental/physical capacity. The guardian may retain legal, financial, property management, or medical experts to assist in writing the plan (Rausch, 1998).

Private disability management services can be employed and given the authority to act on behalf of the grantor. POAs, DPOAs, and HCPOAs can be used to transfer decision-making authority in general or specified areas. Using these methods presumes that a person is competent. Arrangements made when a person is competent supersede any later findings of incompetency and any appointment of a guardian.

Pooled trusts are also available to assist in healthcare planning and resource management. A pooled trust can be set up by the individual, his durable power of attorney, or through the Court for the purpose of transferring the ownership of assets from the individual to the trust. By doing so, the individual may then be able to qualify for government benefits that he would otherwise be ineligible to receive due to income and asset limits. Disbursement from a pooled trust requires a distribution authorization be signed by the individual beneficiary requesting that bills be paid and/or services purchased. Disbursement of funds is made directly to the vendor so that the money does not pass into the possession of the individual beneficiary. The trustee can be either an individual or a private, non-profit corporation.

Generally, an individual trustees or trust organizations primary responsibility is to manage funds, dispense checks, and maintain records. It would be advantageous for the trustee or trust organization to have the guidance of a knowledgeable professional when making healthcare decisions and purchasing goods or services. The rehabilitation counselor is well-qualified to function as that knowledgeable professional. The rehabilitation case manager, serving a consultant to either the individual or the trust, can be retained to prepare an individualized care plan or review existing plans. The rehabilitation counselor can also ensure that distributions meet the beneficiary's goals and objectives as identified in the original care plan and that the terms and conditions of any benefits program in which the individual is enrolled are not violated. Rehabilitation case managers also are knowledgeable about community resources and can assist in making informed decisions regarding the purchase of necessary goods and services. Furthermore, the case manager can assist in identifying needs that might arise as a result of changes in the beneficiary's circumstances.

Special needs trust are designed for people under the age of 65 who need to retain qualifying ability for government programs with assets or income thresholds and operates in a similar manner to a pooled trusts. Special-needs trusts are frequently used to receive money from personal injury settlements. In many instances, years may elapse between the time of injury and the payment of a settlement. During the interval, government benefits are typically applied for and received, but payment of a settlement often disqualifies a person for further benefits including health insurance. As maintaining these benefits are paramount, a special needs trust is a useful instrument for maintaining eligibility for government benefits, such as Medicaid, Social Security income, or other income qualifying programs.

A special needs trust can be established by the individual, if competent, through a durable power of attorney or through the finding of a Court after a petition has been made. The trust retains fiduciary responsibilities and check signature authority. In order to establish a special needs trust, an interested party must petition the court on behalf of an individual in need, outlining the rationale for the establishment of the trust.

Maintenance of Public Benefits

With regard to resource management, it is important that special attention be given to maintaining eligibility for public benefits (Social Security, Medicaid, etc.). Under current federal law, any assets held in trust or otherwise will be counted against recipients of public benefits. Any portion of the trust funds that can be reached by the individual will be counted as an asset and any portion of the interest that could be paid out will be counted as income. The result is that a recipient of a public benefit, such as Medicaid, will be disqualified and their benefits cut off. In the case of someone who is applying for benefits, the application for public benefits will be denied. A trusts can be set up to transfer the ownership of assets to insure competent financial management, preserve government benefits, or to avoid probate. A pooled trust creates a specific exception to the rules that normally apply to trusts. Persons who place assets in a pooled trust can avoid having those assets counted as available resources and can avoid having the interest counted as income, allowing the individual to continue receiving public benefits for meeting essential needs and still have resources available for their special or supplemental needs (Florida Pooled Trust, 1999).

It is increasingly important that care managers have an understanding of government benefits and community resources. In many instances, failure to consider the impact of a personal injury recovery, inheritance, or accumulation of assets that disqualifies a person from government benefits can have malpractice implications.

Areas of Opportunity for Rehabilitation Counselors

There is a growing recognition of the need to plan for aging or disability. State Bar Associations are setting up areas of practice called elder law to put legal mechanisms in place to meet the anticipated demand for these services. Many attorneys are offering health care planning, resource management, and case management services. Financial planners are beginning to address similar issues and retaining attorneys to set up the legal documents. Accountants also are starting to develop expertise in this area. Regardless of the profession that initiates the planning, the same central issues of healthcare planning, disability management and resource management must be addressed. In most cases these professionals are able to set up the structure, instruments or vehicles that provide for the distribution of funds, but are not qualified to make decisions regarding healthcare and disability issues. Furthermore, attempting to do so without guidance or consultation increases their liability and the potential for conflicts of interest. Each of these areas of practice represents a potential referral source for rehabilitation counselors seeking to provide services to aging clients. Rehabilitation counselors are uniquely trained and qualified to serve as managers of POAs, DPOAs, and HPOAs and, as this field is still in the incubation stage, counselors can mold their practice to suit their individual interest.

Special-needs trusts or pooled trusts offer another area of significant opportunity to rehabilitation counselors. As a practical matter, and by statute in some instances, life care or case management plans are required with the establishment of the trust. Rehabilitation counselors can serve as case managers to beneficiaries of the trust, or they can serve as consultants to a trust to coordinate planning and make recommendations of appropriate expenditures, retention of necessary experts, and determination of attainable goals. As we have seen, rehabilitation counselors are also uniquely qualified to serve on examining committees when the court is petitioned to determine competency. Opportunities also exist for rehabilitation counselors as professional guardians, life care planners and/or providers of disability management services.

It is important to note that these opportunities often come with multiple challenges. Rehabilitation counselors working in these venues are required to make life impacting decisions such as authorizing surgeries, placement in long-term care facilities, financial decisions, dealing with income qualifying government benefits, making decisions based on 'do not resuscitate, and in some instances even making burial arrangements. Adversarial situations will occur with family members, with vendors, attorneys, or trustees. Counselors who choose this area of practice must remain current in a variety of disciplines such as rehabilitation, elder law, financial planning, advocacy guardianship, mental health counseling practices, and case documentation.

A common body of knowledge, as with all other true professions, should underlie the practice of providing effective rehabilitation services (Syzmanski, et al., 1993). In light of the various rehabilitation counselor practice opportunities, a credentialing process was derived for ensuring that individuals providing such services shared this common body of knowledge. Rehabilitation counselors demonstrate their command of this knowledge base by sitting and passing a national examination, the Certified Rehabilitation Counselor (CRC) examination. If rehabilitation counselors are to provide an array of specialized services, the public and employers should be assured that such persons possess a minimal level of competency. The purpose of certification is to enable the public and employers to identify those practitioners who meet a standard that is set above the minimal level required for licensure (Matkin, 1983).

Certifications and Training

Lifecare planning and case management appear to be part of a continuum rather than separate practice areas. Certified Rehabilitation Counselors (CRC), Certified Disability Management Specialists, Certified Case Managers, Certified Lifecare Planners, and Certified Master Guardians share similar requirements for certification, including a minimum level of education, a minimum number of clinical hours under the supervision of a credentialed field supervisor, the passing of a national examination for certification, competencies in similar practice activities such as case management and adherence to a respective code of ethics.

The CRC credentialing process is considered to be the oldest and most established certification mechanism in the counseling and rehabilitation profession (Leahy & Holt, 1993). Rehabilitation counselor certification is the purview of the Commission on Rehabilitation Counselor Certification (CRCC) (Syzmanski & Leahy, 1993). The CRCC establishes CRC application criteria and publishes such requirements in its certification guide. Eligibility criteria are listed in the CRCC certification guide that identifies minimum educational, internship and employment experiences for each category. Across all categories, applicants are required to possess a master's degree, and a specific number of clinical hours under the supervision of a CRC depending upon the category for eligibility. The CRC should demonstrate knowledge of facilitating adjustment to medical and psychosocial impact of disability, client assessment, and service/treatment planning (CRC Certification Guide, 2002). A certified rehabilitation counselor must pass the national CRC board and he/she is expected to adhere to CRCC's professional code of ethics.

The Certified Disability Management Specialist (CDMS) credential is administered by the Certification of Disability Management Specialist Commission (CDMSC). Certification as a rehabilitation counselor or registered nurse is acceptable for this credential. Employment experiences for eligibility vary with differing degree requirements. For example, an applicant with a master's degree in rehabilitation counseling would be required to document 12 months employment or internship/practicum in the field of disability management. On the other hand, an applicant with a bachelor's degree and license or certification in an appropriate field would be required to possess 24 months of employment, with 12 under the supervision of a CDMS, CCM or CRC. Similar to the CRC, the CDMS is expected to demonstrate knowledge of medical and psychological aspects, assessment and case management (Criteria for Certification Renewal Manual, 2000). The passing of a national certification examination, the CDMS examination, and the adherence to the CDMSC's published profession codes of ethics are required by all CDMSs.

The Commission for Case Manager Certification (CCMC) establishes the competencies for the Certified Case Manager (CCM) credential. CCMs will hold a postsecondary degree in a health care related field and will have demonstrated an expertise in assessment, coordination, planning, monitoring, implementation, and evaluation of disability (CCMC, 2001). Specific expertise in addressing relationships, healthcare management, community resources, service delivery, psychosocial intervention, and rehabilitation case management is expected. Prior to achieving the CCM credential, applicants must likewise pass a national certification examination, the CCM examination.

The life care planning process first appeared in the professional literature around 1981, and has since gained widespread acceptance. The development of a comprehensive life care plan has always been considered to be an integral part of the vocational rehabilitation process. Life care planning is essentially a case management process and tool that is used in the health care field by nurses, rehabilitation counselors, rehabilitation psychologists, psychiatrists and other health related professionals acting as Board Certified or Board Eligible case managers and/or counselors specifically trained to plan for and manage catastrophic disability and chronic illness from onset through life expectancy.

A postsecondary degree in a health related field and expertise in the same areas outlines under the CRC, CDMS and CCM are needed for generating optimal outcomes thorough planning, prevention and restoration. Although a nationally certifying board for the life care planner does not exist at present, several academic and clinical entities have developed curriculums/training modules for providing such professionals with necessary skills and subsequent certification. One such certification program is demonstrated by the partnership between the University of Florida and Intelicus Certification Program in Life Care Planning which prepared individuals for the national Certified Life Care Planning (CLCP) credential.

A master's degree and three years of experience as a guardian or a bachelor's degree and five years experience is required for the master guardian. In the absence of a degree, 12 years of experience is needed. Competence is required in managing complex issues, significant financial estates, assessment of needs, experience with more than one disability group, and consultation regarding medical procedures, medications, and behavioral programs. The aforementioned professional practice areas appear to focus on a similar constellation of experience and expertise.

Conclusion

Rehabilitation counselors possess a wide array of skills that can be applied in multiple venues. Traditionally, rehabilitation counselors have been employed primarily in state or federal vocational rehabilitation or community based rehabilitation facilities. Counselors in the private sectors have focused largely on return to work of the industrially injured or have been employed by insurance companies. However, meeting the long-term care and resource management needs of older individuals is a growing field of practice that rehabilitation counselors are uniquely suited for and should consider pursuing.

References

Akabas, S. H., Gates, L.B., & Galvin, D.E. (1992). Disability management: A complete system to reduce costs, increase productivity, meet employee needs, and ensure legal compliance. New York: AMACOM.

Certification of Disability Management Specialist Commission (2000). Criteria for certification renewal and continuing education. Rolling Meadows, IL. Author.

Commission for Case Managers Certification (2001, December). CCM certification guide. Rolling Meadows, IL: Author.

Commission on Rehabilitation Counselor Certification (2002, June). CRC certification guide. Rolling Meadows, IL: Author.

Commission on Rehabilitation Counselor Certification (2002). Code of Ethics for Rehabilitation Counselors. [On line]. Available http://www.crccertification.com

Corey, G., Corey, M.S., & Callanan, P. (1993). Issues and ethics in the helping professions, (Fourth edition). Pacific Grove, CA: Brooks/Cole.

Goodwin, B.A., Taylor, D.W., Fong, C., & Currier, K. (2000). Perceived training needs of disability management specialists in five knowledge domains of Disability Management practice. Rehabilitation Education, 14, 229-241.

Leahy, M. J., & Holt, E. (1993). Certification in rehabilitation counseling: History and process. Journal of Applied Rehabilitation Counseling, 24, 5-9.

Matkin, R. E. (1983). Credentialing the rehabilitation profession. Journal of Rehabilitation, 3, 25-38.

Melton, G.B., Petrila, J., Poythress, N.G., & Slobogin, C. (1997). Psychological evaluations for the courts. New York: Guilford Press.

Rausch, I. (1998). A practical guide to guardianship. Palm Harbor, FL: Pine Cone Publishing.

Rubin, S.E., & Roessler, R.T. (2001). Foundations of the vocational rehabilitation process. (Fifth edition). Austin, TX: Pro-ed.

Schwartz, G.E., Watson, S.D., Galvin, D.E., & Lipoff, E. (1989). The disability management source book. Washington, DC: Washington Business Group on Health/Institute for Rehabilitation and Disability Management.

Szymanski, E. M., & Leahy, M. J. (1993). Prologue: Rehabilitation counseling credentialing: Research and practice. Journal of Applied Rehabilitation Counseling, 24, 3-4.

Szymanski, E. M., Linkowski, D. C., Leahy, M. J., Diamond, E. E., & Thoreson, R. W. (1993). Validation of rehabilitation counseling accreditation and certification knowledge areas: Methodology and initial results. Journal of Applied Rehabilitation Counseling, 24, 24-31.

Ray H. Doyle, MA, CRC, 1718 7th Ave., Suite 201, Ybor City, P.O. Box 2850, Brandon, FL 33509. Email: [e-mail]

Ray H. Doyle Jr.
Ray H. Doyle Jr. & Associates

Charlotte G. Dixon
University of South Florida

Corey L. Moore
Langston University