Young Adults in Transition: Vocational Rehabilitation Services: Part 4

Required Vocational Rehabilitation Services (VR Services)

VR services are any services, described in an IPE, necessary to assist a person with a disability in “preparing for, securing, retaining, advancing in, or regaining an employment outcome that is consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and Informed Choice of the individual.”

Even if a state limits VR services by going to an “Order of Selection,” the VR Agency must serve each applicant for services who is in a category that is eligible to be served, and it must provide all needed services to each individual it serves. For more on VR Order of Selection, see Part 1 of this guide series.

The services that are available from the VR system are incredibly broad and varied. Essentially, whatever an individual with a disability needs to overcome his or her barrier to employment can be covered.

ADVOCACY TIP  |  The services available from the VR system are incredibly broad and varied. Encourage students and parents to learn about the full range of required services, both to them as an individual, and to any potential employer.

VR services must include, but are not limited to, the following:

1. The assessment to determine eligibility and needs (if appropriate, conducted by someone skilled in rehabilitation or assistive technology);

2. Counseling, guidance, and job placement services and, if appropriate, referrals to the services of other agencies including others within the statewide workforce development system;

3. Vocational and other training, including higher education and the purchase of tools, materials and books, which includes:

a) Graduate level training in any field

b) “Tuition and other services for students with intellectual or developmental disabilities in a Comprehensive Transition and Postsecondary Program for Students with Intellectual Disabilities, as defined by the Higher Education Act of 2008”;

4. Diagnosis and treatment of physical or mental impairments to reduce or eliminate impediments to employment, to the extent financial support is not available from other sources, including health insurance or other comparable benefits. This may include:

a) Dentistry

b) Nursing services

c) Corrective surgery or therapeutic treatment

d) Diagnosis and treatment for emotional disabilities

e) Necessary hospitalization

f) Medications and supplies

g) Prosthetic and orthotic devices

h) Eyeglasses and visual services

i) Podiatry

j) Physical therapy, occupational therapy, speech, or hearing therapy

k) Treatment of either acute or chronic medical complications or emergencies

l) Services for individuals with end-stage renal disease, including dialysis, transplants, and artificial kidneys

m) Diagnosis and treatment for mental or emotional disorders

n) Other medical or medically related rehabilitative services;

5. Maintenance for additional costs incurred during rehabilitation;

6. Transportation, defined as “travel and related expenses that are necessary to enable an applicant or eligible individual to participate in a [VR] service.” Additionally, “[t]he purchase and repair of vehicles, including vans” is an example of an expense that would meet the definition of transportation;

7. Personal assistance services while receiving VR services;

8. Interpreter services for individuals who are deaf. For individuals who are blind, readers, rehabilitation teaching, and orientation and mobility services can be provided;

9. Occupational licenses, tools, equipment, initial stocks, and supplies;

10. Technical assistance for those who are pursuing telecommuting, self-employment or small business operation;

11. Rehabilitation technology (i.e., AT), including vehicular modification, telecommunications, sensory and other technological aids and other technological aids and devices;

12. Transition services for students with disabilities to facilitate the achievement of the employment outcome identified in the IPE;

13. Supported employment;

14. Customized employment;

15. Services to the family to assist an individual with a disability to achieve an employment outcome;

16. Other goods and services determined necessary to enable the individual with a disability to achieve an employment outcome;

17. Post-employment services necessary to assist an individual to maintain, regain, or advance in employment.

VR agencies may also provide services to employers who have hired or are interested in hiring individuals with disabilities, including:

(a) Providing training and technical assistance to employers regarding the employment of individuals with disabilities, including disability awareness, and the requirements of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.) and other employment-related laws;

(b) Working with employers to—

1. 1. Provide opportunities for work-based learning experiences (including internships, short-term employment, apprenticeships, and fellowships),
   2. Provide opportunities for preemployment transition services, in accordance with the requirements under 34 C.F.R. 361.48(a),
   3. Recruit qualified applicants who are individuals with disabilities,
   4. Understand how to train employees who are individuals with disabilities, and
   5. Promote awareness of disability related obstacles to continued employment;

(c) Providing consultation, technical assistance, and support to employers on workplace accommodations, assistive technology, and facilities and workplace access through collaboration with community partners and employers, across States and nationally, to enable the employers to recruit, job match, hire, and retain qualified individuals with disabilities who are recipients of vocational rehabilitation services under this part, or who are applicants for such services; and

(d) Assisting employers with utilizing available financial support for hiring or accommodating individuals with disabilities.

States must develop policies concerning the provision of VR services. These policies must ensure that services are provided based on each person’s individual needs. They may not place “any arbitrary limits on the nature and scope of” VR services that are provided to achieve an employment outcome. The VR agency may establish reasonable time periods for the provision of services, but they must not be so short as to effectively deny a service and they must “permit exceptions so individual needs can be addressed.”

Similarly, the state’s policies on the rates of payment for services must not be so low as to effectively deny an individual a necessary service and may not be absolute.

Finally, the policies must include provisions for the timely authorization of services, “including any conditions under which verbal authorization can be given.”

Assistive Technology Services

When a person has become eligible for VR services, VR agencies must consider Assistive Technology (AT) devices and services needed to develop and achieve employment goals.

The VR agency may deny funding for AT devices and services if they are required to be provided as “auxiliary aids or services” by another agency or organization, under the ADA or Section 504 of the Rehabilitation Act (Section 504).

Once a person has been determined eligible for VR services, and if there is no other responsible party, e.g., the school and/or Medicaid, the VR agency must pay the full cost of AT devices and services, and they are not subject to Financial Participation cost sharing rules.

The VR agency may review existing evaluations regarding the need for AT devices and services, or it may conduct its own assessments and evaluations.

If a person needs AT devices or services to participate in new evaluations during the development of the IPE, or during trial work experiences, the VR agency is required to provide them so they can participate meaningfully in the IPE development.

If the VR agency provides AT devices, then it must also provide training on how to use the devices to the individual and any other persons who may be required to assist in their use.

Personal choices and preferences of AT devices are important factors for the VR agency to consider. However, they are not the only factor. The VR agency may consider cost in selecting the device. VR agencies are not required to buy the most expensive device if a less expensive device will be effective in helping the individual reach their goal.

The individual has a right to choose who provides their AT devices and services, including the training that they may need in its use. The VR Counselor must provide them with a list of providers to choose from.

ADVOCACY TIP  |  Students have a right to receive the Assistive Technology devices and services (AT) that they need to participate in assessments, their job, and training. The VR agency must pay the full cost if there is no other responsible party under the ADA or Section 504.

Out-of-State Services

There are times when a VR client needs to attend a program out-of-state because there is no comparable program within the state to prepare the person for the agreed-upon employment goal. Alternatively, the VR client may prefer, for personal reasons, to attend an out-of-state program.

VR regulations allow this choice. A state “may establish a preference for in-state services,” as long as there are exceptions to ensure that an individual is not denied a necessary service. If there is no appropriate program available within the state, the state must have a process to fund the out-of-state program (subject to any financial need criteria the state may have established).

If the out-of-state program costs more than an in-state service, and either service would meet the individual’s rehabilitation needs, the VR system is not responsible for costs in excess of the cost of the in-state service.

ADVOCACY TIP  |  Students don’t have to limit their selection of VR service providers to those in their state of residence, especially if they live near a state border, where other providers may be available. They have a right to select an out-of-state provider if they wish.

Post-Employment VR Services

VR agencies can provide services after the person has achieved an employment outcome, which are necessary for the individual “to maintain, regain, or advance in employment.” Maintaining employment may be necessary if the person’s employment is jeopardized because of issues related to their disability. Examples might include:

1. conflicts with supervisors or coworkers related to the person’s disability;
2. the person needs mental health services and counseling to maintain the employment;
3. the person requires assistive technology to maintain the employment;
4. the person needs to regain employment, for example if the persons’ job is eliminated through reorganization and new placement services are needed; and
5. if the person needs to advance in employment, for example if the employment is no longer consistent with the person’s unique strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice.

The IPE must indicate whether post-employment services are expected or needed. VR agencies must also inform the person of the availability of post-employment services before closing their case.

ADVOCACY TIP  |  The IPE must include Post-Employment VR services. The VR agency is required to inform the individual about post-employment services before closing their case. These services are available to ensure they are able to “maintain employment” and/or “advance employment.” Individuals should contact the VR Counselor and consider changing or requesting additional Post Employment services in the IPE from their VR counselor if they anticipate needing them due to changes in skills, workplace conditions, interests, etc. as soon as they become aware of them.