1. Vocational Rehabilitation Services Client Assistance Program
Leilani Pfeifer, Multicultural Affairs Coordinator/CAP Advocate
Michael Thomas, PABSS Coordinator/CAP Advocate
2/7/13 – 3:00 p.m. – 4:15 p.m.
Patients’ Rights Advocacy Training 2013

3. Vocational Rehabilitation Services
Client Assistance Program (CAP)

4. AREA 1 and 5: Northern Sierra and San Joaquin Valley CAP Advocates
Introduction
AREA 1 and 5: Northern Sierra and San Joaquin Valley CAP Advocates
Michael Thomas
Leilani Pfeifer

5. The Purpose of the Vocational Rehabilitation Program
Help individuals with disabilities become employed and self-sufficient.

6. Individuals in the Vocational Rehabilitation Program
According to the Rehabilitation Service Administration’s (RSA) Annual Review Report FY 2010
California Department of Rehabilitation
10,719 Individuals achieved employment outcome in FY 2010
Out of the 10,719
2,777 individuals were identified as having mental health and emotional disability
Employment rate 35%
Average hourly rate earnings $11.47
CAP assisted 239 individuals

7. Policy of the United States as Adopted by Congress
That Individuals with Disabilities be provided the opportunities to obtain gainful employment in INTEGRATED settings.
That Individuals with Disabilities are to be ACTIVE and FULL partners in the VR process making meaningful and informed choices.

8. Role of the Department of Rehabilitation (DOR)
Administer the Vocational Rehabilitation (VR) programs.
Provide applicants and individuals eligible for service opportunities to exercise informed choice throughout the VR process.
Work with VR clients and applicants to make decisions about employment goals, VR services and service providers, settings for employment and service provisions.

9. Role of the Department of Rehabilitation (cont’d)
Provide services necessary to assist in “preparing for, securing, retaining, or regaining an employment outcome that is consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the individual.”

10. Phases of the VR Process
Application for VR services.
Determination of Eligibility (within 60 days)
Development of the Individualized Plan for Employment (IPE).
Provision of VR Services.
Employment – the ultimate goal! – and Closure of VR Case.
Post-employment services (if applicable)

11. Application for VR Services
Apply online via the California Department of Rehabilitation website
Mail the attached application form to your local Department of Rehabilitation office.
Call your local Department of Rehabilitation office and request that an application be mailed to you.
Visit your local Department of Rehabilitation (DOR) office in person and complete an application in person.
You may give the information needed to start the assessment process in another reasonable format to DOR.

12. Who Is Eligible For VR Services?
In order to be determined eligible to receive VR services, the individual must have:
A Physical or Mental Impairment which is a;
A Substantial Impediment to employment;
A Need for Vocational Rehabilitation services to “prepare for, secure, retain, or regain employment;” and
Can benefit from Vocational Rehabilitation services (this is presumed unless DOR can provide “clear and convincing evidence” to the contrary).

13. Clear and Convincing Evidence to Determine Ineligibility
The VR agency may determine a person ineligible for services by showing clear and convincing evidence that the individual is not capable of benefiting from VR services.
In order to demonstrate clear and convincing evidence, the VR agency must conduct an assessment of ability by the use of trial work experience (TWE), as well as conduct an extended evaluation if the trial work experience does not provide sufficient information to determine if the individual can benefit from services.

14. Who is Presumed Eligible?
SSDI/SSI - Beneficiaries of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are presumed eligible to receive VR services.
However, SSI/SSDI beneficiaries can still be found ineligible for services if the VR agency provides clear and convincing evidence that the individual cannot become employed even with VR services.

15. When will DOR Make an Eligibility Determination
The DOR will make a determination regarding eligibility within a reasonable period of time, not to exceed 60 days, after receiving the application for services.
This timeframe may be extended in order to conduct Trial Work Experience (TWE) or due to “exceptional and unforeseen circumstances beyond the control” of the DOR. In this unique situation, the DOR and the individual will agree to a specific extension of time.

16. The Individualized Plan for Employment (IPE)
The individualized plan for employment is a critical document in the vocational rehabilitation (VR) process.  The IPE contains important information on your employment goal, the VR services necessary to reach your employment goal, and the services the Department of Rehabilitation (DOR) will provide. 

17. Informed Choice: A Critical Component
The IPE should be developed, implemented and evaluated in a cooperative relationship between the client and the DOR counselor.  Rehabilitation Act regulations state that “the IPE shall be developed and implemented in a manner that affords the eligible individual to exercise “informed choice” in: 
Selecting an employment outcome;

18. Informed Choice: A Critical Component (cont’d)
The specific vocational rehabilitation services to be provided under the plan;
The entity that will provide the vocational rehabilitation services, and
The methods used to procure the services

19. Maximizing Employment
“The State VR Services program is not intended to solely place individuals with disabilities in entry level jobs, but rather to assist eligible individuals obtain employment that is consistent with their unique strengths, resources, priorities, concerns, abilities, and capabilities.”
RSA Policy Directive, Employment Goal For An Individuals With A Disability, RSA-PD

20. Rehabilitation Services:
Any services provided or funded by DOR must be specified on the IPE.  All IPE services must be provided in the most integrated setting that is both appropriate and reflects the informed choice of the individual.   

21. Other criteria of the IPE…
The IPE must: 
Be developed in a timely manner subsequent to the determination of eligibility (California law states 90 days);
Be designed to achieve the specific employment outcome selected by the individual with the disability;
Be consistent with the individual’s unique strengths, resources, priorities, concerns, abilities, capabilities, interest and informed choice;
To the maximum extent appropriate result in employment in an integrated setting;
Be a written document prepared on DOR forms;
Article 5. The Individualized Plan for Employment (IPE)
§ General Requirements. (Development of an IPE)
Department and is in a priority category being served under an Order of Selection implemented pursuant to Section 7053 of these regulations, the IPE must be developed within 90 days from the date of the eligibility determination, i

22. Other criteria of the IPE… (cont’d)
Be designed to include a description of services;
Be implemented in a manner that gives the eligible individual the ability to exercise informed choice in selecting the entity to provide vocational rehabilitation services;
Be designed to include information regarding related services and benefits;
Agreed to, and agreed on by, each eligible individual or, as appropriate, the individual’s representative;

23. Other criteria of the IPE… (cont’d)
Approved and signed by a qualified vocational rehabilitation counselor employed by DOR;
Be copied to ensure that the individual has his/her own copy of the final document, and
Be reviewed on at least an annual basis by the individual and a qualified vocational rehabilitation counselor, and if necessary, amended if there are substantive changes in employment outcome, the services to be provided or;

24. Provision of VR Services
VR services must be provided as appropriate to the vocational rehabilitation needs of each individual consistent with each individual's informed choice, to assist the individual with a disability in preparing for, securing, retaining, or regaining an employment outcome that is consistent with the individual's strengths, resources, priorities, concerns, abilities, capabilities, and interests.

25. Provision of VR Services (cont’d)
DOR must ensure that the following VR services are available:
Assessment for determining eligibility and priority;
Assessment for determining vocational rehabilitation needs by qualified personnel;
Vocational rehabilitation counseling and guidance; Information and referral;
Physical and mental restoration services;
Vocational and other training services;
Maintenance;
Transportation;
Vocational rehabilitation services to family members;
Article 4. Physical and Mental Restoration Services
§ Physical and Mental Restoration Services/Purchases-General.
(4) Prescribed/recommended by the attending physician, except as provided in Section (a)(4).
(5) Reviewed/approved in writing prior to the provision of the service/purchase, except as provided in (c) and in accordance with (b), by one or more of the following as appropriate to the service being rendered or the purchase being authorized:
(b) Approval shall occur only after reaching a conclusion, based upon a careful review of the diagnostic study, that the IWRP will be jeopardized if the service/purchase is not provided and the conditions in either (1) or (2) exist:
(1) For persons in extended evaluation, the service is necessary to determine eligibility for vocational rehabilitation services.
(2) For clients eligible for vocational rehabilitation services, the service is necessary to both:
(A) Correct or substantially modify, within a reasonable period of time, a physical or mental condition which is stable or slowly progressive. A reasonable period of time shall be determined based upon factors related to the nature of the disability.
Prepare the client for suitable employment.
§ Limitations on Physical and Mental Restoration Services.
(b) Dental services shall be provided after receipt of a dental plan and
x-rays submitted by a dentist/orthodontist. Prior approval of the State Dental Consultant is required if the dental restoration program is in question, if service has been denied by Medi-Cal or if service includes extensive treatment such as maxillo-facial dental service, maxillo-facial prosthetics, gold or porcelain/gold crown, root canal treatment, surgical gum treatment, full or partial dentures or bridges.
Article 1. General Provisions
§ Scope of Vocational Rehabilitation Services for Individuals
with Disabilities.
(e) Physical and mental restoration services, in accordance with Section 7020 of these regulations, to the extent that financial support is not readily available from a source other than the Department.
(g) Maintenance, as defined in Section 7019 and provided under conditions specified in Section 7177 of these regulations.
(h) Transportation provided to enable participation in any vocational rehabilitation service, in accordance with the definition in Section 7029 of these regulations.
§ Transportation Services---General.
(1) Shall be provided as a supportive service when necessary to provide for those travel expenses resulting from:
(C) The client's participation in a completion of an approved program of vocational rehabilitation services.
(4) Shall be provided only to a client who is engaged in suitable employment as defined in section 7184 under either of the following circumstances:
(c) The mode of transportation provided shall be the least costly mode which meets the special needs of the client. Modes of transportation include, but are not limited to:
§ Services to Family Members.
(a) Any vocational rehabilitation service may be provided to a member of a client's family if the service is necessary to support the client's vocational adjustment or vocational rehabilitation.
(b) The services provided to a family member or members shall be based on an evaluation of the client's needs which includes:
(1) Problems faced by the family in support of the client's rehabilitation; and
(3) A determination that without such services the client would be unable to achieve suitable employment.

26. Provision of VR Services (cont’d)
Interpreter services;
Reader services, rehabilitation teaching services, and orientation and mobility services for individuals who are blind;
Job-related services;
Supported employment services;
Personal assistance services;
Post-employment services;
Occupational licenses, tools, equipment, initial stocks, and supplies;
§ Post-Employment Services.
(a) The purpose of post-employment services is to maintain suitable employment and preserve the gains made through the client's vocational rehabilitation.
(b) If services have been planned for during an IWRP or specific services were not anticipated, but are required to maintain a client's employment and/or preserve the gains made during a client's vocational rehabilitation, then a program of post-employment services may be provided.

27. Provision of VR Services (cont’d)
Rehabilitation technology;
Transition services
Technical assistance and other consultation services to eligible individuals who are pursuing self-employment or telecommuting or establishing a small business operation as an employment outcome.
Other goods and services determined necessary for the individual with a disability to achieve an employment outcome.
Other goods and services can be internet, expenses under $100 that a rehab counselor can approved that is requested by the client based on its employment goal (IPE).

28. Closure of VR Case The employment outcome has been achieved.
The employment is maintained for at least 90 days, is stable, and the individual no longer needs VR service.
The individual and the VR counselor agree the individual is satisfied and is doing well in the job.

29. Client Assistance Program (CAP)
CAP is designed to help the consumer and their representative understand their rights and responsibilities and assist them in presenting their concerns to DOR.
CAP advocates are not employees of DOR, they serve as independent advocates.
Clients and applicants of DOR may request for CAP’s assistance at any point from the time of application until after case closure.

30. What Services Does CAP provide?
CAP advocates may provide:
Information and referral
Counsel and advice;
Brief Service;
Technical assistance to clients preparing for Administrative Review, Mediation and or Fair Hearing;

31. Q & A

32. THANK YOU