i New Mexico State Board of Education
ii Use of the Manual
iii Record of Revisions
1.00 The Vocational Rehabilitation Process
2.00 Status 00 - Referrals
3.00 Status 02 - Applicant/Preliminary Assessment
3.01 Basic Requirements
3.02 Initial Interview
3.03 Preliminary Assessment
4.00 Eligibility
4.01 Basic Requirements
4.02 Physical or Mental Impairment & Functional Limitations
4.03 Substantial Impediment to Employment
4.04 Can Benefit in Terms of an Employment Outcome
4.05 V.R. Services Required
4.06 Ineligibility
5.00 Status 06 - Extended Evaluation
6.00 Status 10 and 12 - Comprehensive Assessment
7.00 Individualized Written Rehabilitation Program
7.01 Basic Requirements
7.02 Contents of the IWRP
7.03 Amendments to the IWRP
7.04 Cost Sheet
8.00 Purchase of Goods and Services
8.01 Economic Needs Requirement
8.02 Comparable Services and Benefits
8.03 Payment for Services
8.04 Occupational Licenses, Goods and Equipment
(Revised 4/96)
8.05 Purchase of Vehicles
9.00 Status 14 - Counseling and Guidance
10.00 Status 16 - Physical and Mental Restoration
10.01 Basic Requirements
10.02 Physical Restoration
10.03 Medical Consultation
10.04 Mental Restoration
11.00 Status 18 - Training
11.01 Vocational Training
11.02 College or University Training
11.03 On-the-Job Training
11.04 Work Adjustment Training
11.05 Miscellaneous Training
12.00 Other Services
12.01 Maintenance
12.02 Transportation Services
12.03 Services to Family Members
12.04 Other Miscellaneous Goods and Services
13.00 Placement & Employment
13.01 Status 20 - Placement
13.02 Status 22 - Employment
13.03 Homemaking
13.04 Unpaid Farm or Family Worker, and Other Homebased Employment
13.05 Extended Employment
13.06 Self Employment
14.00 Supported Employment
14.01 Basic Requirements
14.02 Eligibility
14.03 Scope of Service
14.04 IWRP for Supported Employment
14.05 Case Closure
14.06 Documentation
14.07 Post Employment Services
(Revised 4/96)
15.00 Case Closure
15.01 Status 08 - Closure
15.02 Status 24 - Interrupted Status
15.03 Status 26 - Closure
15.04 Status 28 and 30 - Closures
15.05 Closure Notification
16.00 Post Employment (Status 32, 34 and 36)
17.00 Client Rights and Responsibilities
17.01 Basic Rights
17.02 Protection, Use and Release of Information
17.03 Fair Hearing
18.00 Case Documentation
18.01 Contact Reports
18.02 Filing Procedures for Case Files
18.03 Transfer of Cases
Index
(Revised 4/96)
Eleanor B. Ortiz, President Santa Fe
Van W. Witt, Vice-President Roswell
Emmalou Rodriguez, Secretary Albuquerque
Virginia Trujillo, Member Albuquerque
Wallace Davis, Member Ship Rock
Roger X. Lenard, Member Edgewood
Millie Pogna, Member Albuquerque
Lynn Medlin, Member Tatum
Darl N. Miller, Member Las Cruces
Catherine M. Smith, Member Mimbres
Steven Schmidt, Member Santa Fe
Rudy Castellano, Member Questa
Marlis Mann, Member Corrales
Beverlie O’Dell, Member Los Alamos
The New Mexico State Board of Education and the State Department of Education do not discriminate with regard to race, culture, ancestry, color, national origin, sex, age, religion, or handicap in their programs or hiring. practices.
This project was funded, in part, by a Rehabilitation Act of 1973 Basic Support Grant, HI26A00045, U.S. Department of Education, Office of Special Education and Rehabilitation Services, Rehabilitation Services Administration and New Mexico State General Funds.
Revised 4/96) -i-
This manual supercedes all previous manuals, memorandums, verbal instructions or other policies related to the provision of client services. The manual and any changes to the manual are effective upon receipt.
The supervisor is responsible for ensuring that each staff member has an updated copy, and that braille copies are provided as needed. After the initial training, the supervisor is also responsible for providing any additional training to new staff, clarifying policy questions for the staff, and bringing problems with the manual to the attention of the Deputy Director of Rehabilitation Services.
The manual is written primarily to cover most situations - not the exception. The individualized nature of the program restricts our ability to address every conceivable service issue that may arise. Counselor skills, good judgement and fiscal responsibility complementing altruism are still imperative requirements for serving clients within the framework of this manual. With these things in mind no eligible client shall be denied a service that is truly needed to achieve a vocational goal, and when this requires an exception to the manual, the supervisor shall bring it to the Field Operations Director. As changes are made to the manual, they will be sent to all manual holders with a cover memo transmittal.
(Revised 4/96) -ii
This form should be filed in front of the Manual of Operating Procedures. When a revision is made, appropriate information should be filled in below:
(Revised 4/96)
Acknowledgment - Changed State Board of Education Members
Table of Contents - 13.05-1 Changed Sheltered Employment to Extended Employment
1.00-3- Added Case Status Movement Table
2.00-2- Outreach - added "NOTE: Institutionalized referrals shall be accepted
if they are available to participate in the rehabilitation process and
employment. Generally, notification of a discharge date from the
institution, or discharge plan, which will allow for active participation
by the individual, shall be required."
- Status 00, Step 1 - changed "R-300 as per Statistical Manual" to
"Information Sheet". Added a step - "Provide information and
explanation of eligibility criteria."
- Temporary Case Number #3 changed "R-300" to "Information Sheet"
4.01-1- Social Security Presumption - Deleted last sentence "See Statistical
Manual for definition of severe disability."
4.01-2- Guidelines #4 - Changed to read: "An individual cannot be served by
more than one state rehabilitation agency. American Indians may be
eligible for services under the state VR program and the American
Indian VR program (Section 13.01) simultaneously, however, IWRP
development must be coordinated to assure appropriate use of
comparable benefits and non-duplication of services."
- Procedures for Eligibility Determination #2 - Deleted "(Refer to
Statistical Manual)".
4.04-1- Can Benefit - changed "decision" to "judgement" on the part of the
counselor ......
7.01-2- Guidelines - Added new guideline "Services provided to individuals who
are also eligible for services under the Individuals with Disabilities Act shall be coordinated. As appropriate, a statement shall be made in the vocational
goal section of the IWRP which describes how it is being coordinated with services planned under an existing IEP or IHP."
7.01-2- changed "Guidelines" numbering sequence.
7.02-2- Guideline #4 - added "if the client does not possess marketable job
skills," and training is required…..
10.04-3- Delete paragraph "Role of the Neuropsychological Consultant".
12.04-3- Independent Living Services - Deleted last paragraph.
13.05-1 &
13.05-2- Changed "Sheltered Employment" to "Extended Employment".
15.01-2- Closing Cases for Unavailability #4 to read: "Complete closure through
DVR NET." -
15.03-2- Closing the Case #7 to read: "Complete closure screens in DVR NET."
15.04-2- Guidelines - Deleted #3
15.05-2- Added Closure Reference Guide Table
18.02-1- Left Side - Delete "On the top of the left side over the first divider (A) is the most recent R-300."
18.03-1- General Guidelines #7 changed to read: "The loosing counselor will enter the Transfer Transaction in the Client Information System identifying the receiving caseload."
1.00-1
1.00 THE VOCATIONAL REHABILITATION PROCESS
LEGAL BASIS:
Legal Authority for VR Programs: The Rehabilitation Act of 1973, as amended, 29 U.S.C.A. Chapter 16, 34 C.F.R. Parts 361 through 396, Section 22-14-7 at seq., NMSA 1978.
OVERVIEW:
The VR process is a Goal Oriented sequence of services provided on an individualized basis to assist eligible persons with disabilities in achieving a vocational goal.
NON-DISCRIMINATION:
The New Mexico. State Board of Education, Department of Education, Division of Vocational Rehabilitation does not discriminate with regard to race, culture, ancestry, color, national origin, sex, age, religion or impairment in their programs or hiring practices.
OVERVIEW OF STATUSES:
In order to describe the rehabilitation process easily and to report client services, the process has been broken down into "client statuses".
(Revised 4/96)
1.00-2
| STATUS | |||
| Referral to VR Agency | Intake, diagnostics and evaluation, potential to determine eligibility. | ||
| Application for VR Services | |||
| Extended Evaluation of Rehabilitation Potential | |||
| Case Closure from Status 00, 02 or 06. | Closure prior to certifying client eligible for VR services. | ||
| Individualized Written Rehabilitation Program (IWRP) Development | Thorough diagnostic study and joint program planning for eligible clients prior to provision of services. | ||
| IWRP Written and Approved | Provision of VR services under an IWRP | ||
| Counseling and Guidance | |||
| Physical & Mental Restoration | |||
| Training | |||
| Placement – Ready for Employment | |||
| Employment | |||
| Services Interrupted | Planned Services Temporarily Discontinued. | ||
| Successful Rehabilitation Closure from Status 22 | Closure after certifying client eligible for VR services. | ||
(Revised 4/96)
1.00-3
| STATUS | |||
| Unsuccessful Closure for Provision of Services from Statuses 14, 16, 18, 20, 22 and 24 | Closure after certifying client eligible for VR services. | ||
| Unsuccessful Closure Prior to Provision of Services from Statuses 10 or 12 | |||
| Post Employment Services After 26 Closure | Provision of VR Services after closure. | ||
| Successful Closure After Post Employment Services | Closure prior to certifying client eligible for VR services. | ||
| Closure indicates Client Did Not Maintain Employment After Post Employment Services | |||
CASE STATUS MOVEMENT:
Below is a chart indicating to which statuses a client may be moved from the current status, if appropriate action or documentation has preceded the status change.
Status changes are made on specific screens in the Client Information System.
| 02, 08 | Information Sheet, Closure Screen 08 from 00 | |
| 06, 10, 08 | Eligibility, Closure Screen 08 from 02 | |
| 10, 08 | Eligibility, Closure Screen 08 from 06 |
(Revised 4/96)
1.00-4
| 00 Then 02 (Open New Case) | Information Sheet | |
| 12, 14, 16, 18, 30 | IWRP Original, Closure 30 Screen | |
| 14, 16, 18, 30 | IWRP Original, Closure 30 Screen | |
| 16, 18, 20, 22, 24, 28 | Status Change Screen, Closure 28 Screen, or IWRP Amendment | |
| 14, 18, 20, 22, 24, 28 | Status Changes, Screen Closure 28 Screen, or IWRP Amendment | |
| 14, 16, 18, 22, 24, 28 | Status Changes Screen, Closure 28 Screen, or IWRP Amendment | |
| 14, 16, 18, 20, 24, 28, 26 | Status Changes Screen, IWRP Amendment,Closure 26 Screen | |
| 14, 16, 18, 20, 22, 28 | Status Changes Screen, Amendment, Closure 28 Screen | |
| 00 Open new case | Information Sheet, Post Employment Screen | |
| 00 Open new case | Information Sheet | |
| 00 Open new case | Information Sheet | |
| 34, 36 | Closure from Post Employment | |
| 00 then 02 (Open New Case) | Information Sheet | |
| 00 then 02 (Open New Case) | Information Sheet |
(Revised 4/96)
2.00 STATUS 00 - REFERRALS 2.00-1
DEFINITION:
A referral is an individual who has been referred to DVR by other agencies, organizations, or individuals and from whom the following information has been obtained:
1. Name and Address
2. Reported Disability
3. Date of Birth
4. Sex
5. Date and Source of Referral
6. Social Security Number
Note: The date on which the referral was actually received by the VR Office must be the same date as the referral date on the Information Sheet.
OUTREACH:
When conducting outreach activities with:
0 Institutions
0 Public or private high schools
0 Social Security offices
.0 Welfare offices
0 Other agencies with several potential referrals at one time
0 Disability Determination Services
(Revised 4/96)
2.00-2
Individual cases may be discussed with a representative of the referring agency prior to referral in order to ensure that referrals are appropriate. Clearly inappropriate cases (such as persons without a disabling condition) should not be referred.
Referrals should be accepted if:
0 the client is available for VR services
0 referral information indicates client may be eligible for VR services
NOTE: Institutionalized referrals shall be accepted if they are available to
participate in the rehabilitation process and employment. Generally,
notification of a discharge date from the institution, or discharge plan,
which will allow for active participation by the individual, shall be
required.
STATUS 00:
STEP: ACTION:
1. Complete Information Sheet.
2. Make a reasonable effort to contact the client.
3. Provide information and explanation of eligibility criteria.
4. Document the "Reasonable Effort" in a contact report.
TEMPORARY CASE NUMBER:
When the referred individual does not have a Social Security Number:
1. Call the client information specialist in the State Office to obtain a
temporary case number and use this number to open the case.
2. Direct the client to apply for a Social Security Number.
3. Change the Information Sheet when the client obtains a Social Security
Number.
(Revised 4/96)
2.00-3
ADVANCING FROM 00:
1. Move to Status 02 if the client responds to the contact, and completes and
signs an application for services. Assistance is given by the VR Secretary or
other staff in completing application if needed.
2. Move to Status 08 if the client does not respond or does not wish to apply for
services. (Section 15.01)
REASONABLE EFFORT TO CONTACT:
An attempt to contact a referral should be made within 30 days of receipt of the referral by letter, telephone or personal visit.
| TYPE OF CONTACT: USE WHEN: |
| Telephone Contact: Phone call to Initially contacting a referral to |
| client, client's relative, guardian or ascertain client's interest in applying |
| other individual familiar with client. for DVR services. |
| Letter includes: Counselor Name, Initially contacting a referral to |
| Address, Phone Number and Referral ascertain clients interest in applying |
| Source. for DVR services or when telephone |
| contact fails to produce a response. |
| Personal or Home Visit: Face-to-face Letter and phone contacts have failed |
| visit with client, or client's parent or and referral information indicates: |
| guardian, in the home, hospital, 1) Visual and/or hearing impairment, |
| institution or other residence. 2) Mental retardation, |
| Personal or home visits may be used 3) Brain damage or learning |
| at referral and must be used for disability, |
| ineligibility decisions. *(See 4) Illiteracy or non-English speaking, |
| exceptions) 5) Client available for services soon |
| but unable to come to the office |
| (hospitalized or institutionalized) |
| 6) Any indication of mobility, |
| communication or transportation |
| problem. |
(Revised 4/96)
2.00-4
EXCEPTIONS TO THE ABOVE:
A home visit is not necessary if:
1. Referral information indicates that the client or someone in the home
may be dangerous.
2. Client has a rural route (R.R.) or post office (P.O.) box address and a
location or street address cannot be established from the referral source.
3. Client has previously refused VR services or referral information
indicates the client may not be interested.
DOCUMENTATION:
Case file should document reasonable effort to contact (letter, telephone, home visit, etc.), and the outcome of such contact.
(Revised 4/96)
3.0 0 STATUS 02
APPLICANT/PRELIMINARY ASSESSMENT
3.01 BASIC REQUIREMENTS 3.01-1
DEFINITION:
1. An applicant is an individual for whom:
11. Preliminary Assessment means:
PURPOSE:
The purpose of this status is to gather diagnostic information sufficient to make a determination of:
NOTE: While a person may be closed in Status 08 for reasons other than
ineligibility, the intent of Status 02 is to make an eligibility
determination. Clients found ineligible, because they cannot benefit
from services in terms of an employment outcome, should be
considered for referral to an Independent Living Program or other
programs as appropriate.
(Revised 10/97)
MOVING INTO 02:
3.01-2
STEP: ACTION:
1. Schedule and conduct an initial interview and document in case file. (Section 3.02)
2. Have the client, parent or guardian (if appropriate) complete and sign an application for VR services.
NOTE: In all cases an explanation of confidentiality, client rights, and the
Client Assistance Program must be given to the client (Section 17.01).
It must be documented by client signature on the application form.
PROCEDURES IN STATUS 02:
STEP: ACTION:
4. To the extent additional data is necessary, arrange for diagnostic
studies. (Section 3.03)
5. Maintain contact with the client to further develop rapport, consider
eligibility and initiate planning when appropriate.
6. Review existing data and assess all information from client and
significant others.
7. If additional data is necessary, do a Preliminary Assessment of such
data.
8. Make an eligibility or case closure decision.
9. Move out of Status 02 to Status 06, 08, 10 or beyond Status 10 (12,
14, 16,or 18).
(Revised 10/97)
3.01-3
10. Complete a 60 day waiver form if the case must be kept in Status 02 beyond the time allowed for eligibility determination. Send a copy of the waiver to the supervisor and complete required section of the Information Sheet on DVRNET for 60 day waiver.
TIME LIMITATION:
Though planning activity may take place in Status 02, the emphasis must be on making an eligibility determination due to the limited time allowed. The counselor must determine whether an individual is eligible for vocational rehabilitation services within 60 DAYS after the individual has submitted an application to receive the services unless:
The general principle to be followed in seeking a waiver of the sixty (60) day limitation for making an eligibility determination pertains to locus of responsibility. In general, it must be for reasons that are clearly beyond the counselor's ability to control. The reasons will usually pertain to the obtaining of data required for an eligibility determination. It is important, therefore, to keep in mind the following: additional (new) data should not be sought if existing data is sufficient; determining sufficiency must be limited to a preliminary assessment of the data; and that, in addition to records, data refers to counselor observations and information obtained from the client during the initial and subsequent interviews.
(Revised 10/97)
3.01-4
In all circumstances, we should maintain a cautious attitude in seeking a waiver.
Before seeking a waiver, always check to see if an eligibility determination can be made. If it cannot, and the reason is:
1. Client related - explain the circumstances to the client and then give them the
option of signing a waiver or having the case closed.
2. Counselor related - explain the circumstances to the client and inquire as to
their willingness to sign a waiver. If they refuse, then you must proceed in
overtime to make an eligibility decision in a conscientious but expeditious
manner. THIS IS IN VIOLATION OF FEDERAL LAW FOR TIME IN
STATUS AND WILL CONSTITUTE AN AUDIT EXCEPTION.
3. Neither - (the circumstances are clearly beyond the counselor's ability to
control but not the client's fault) same as #2 above.
When a waiver has been issued, you must proceed in good faith to make an eligibility decision within the time period agreed upon with the client. The waiver should never be completed for the purpose of obtaining data not required for eligibility or for making decisions which should be made in either status 06 or 10.
GUIDELINES:
1. Keep your intent and purpose on eligibility. The counselor's primary task at
this time is to determine if the client can, not will, achieve an employment
outcome.
2. When feasible, the counselor should base the eligibility decision on a review
of existing data. Do not obtain or collect more data than required to make
an eligibility decision.
(Revised 10/97)
3.01-5
3. To the extent additional data is necessary, remember that only a preliminary
assessment of the data is required. A comprehensive assessment of the same
data, along with additional data as deemed necessary, is reserved for
planning activity in status 10 if the client is found eligible.
4. Focus on basic eligibility issues which require preliminary assessment of
data. Avoid being overly concerned with issues pertaining to vocational
goal, particular services, motivation, etc., which require comprehensive
assessment of data.
5. Avoid the pitfalls which stem from trying to make decisions that are not
meant to be made in status 02. Accept the limits of what can be known and,
thus, must be demonstrated, ie., Status 06 or 10.
ADVANCING FROM STATUS 02:
TO STATUS: ADVANCE TO THIS STATUS WHEN:
08 a) After assessing all information client is declared ineligible
(Section 4.06).
b) Client becomes unavailable for services (Section 4.06).
NOTE: The guidelines listed on page 2.00-3 under "Reasonable
Effort to Contact" must be followed in closing cases from Status
02 to 08. Refer to Section 15.01 Case Closure.
06 Client is certified eligible for extended evaluation services
(Section 5.00).
10 Client is certified eligible for regular VR services (Section
4.00).
12, 14, a) Client is certified eligible
16, 18 for regular VR Services; and
b) Sufficient assessment and planning were done in Status
02 to develop and write an Individualized Written
Rehabilitation Program.
(Revised 10/97)
3.02 INITIAL INTERVIEW 3.02-1
PURPOSE:
The purpose of the initial interview is to:
a) Exchange information with the client.
b) Establish a basis for the client/counselor relationship.
c) Start the preliminary diagnostic process.
GUIDELINES FOR THE INITIAL INTERVIEW:
1. The initial interview must be conducted by a counselor or other qualified
individual. The client should complete the information sheet and health
assessment questionnaire prior to the initial interview, if possible.
2. Have the application, financial summary and the release of information forms
available prior to the interview.
3. Document to the extent necessary an appraisal of the client's current
functioning in the following areas:
a) Medical e) Intellectual
b) Psychological f) Vocational
c) Social g) Financial
d) Educational h) Independent Living
4. Gain as much specific information as possible about the items listed above and
any other areas affecting the client's vocational rehabilitation.
5. If all items cannot be covered adequately, schedule a second interview as soon
as possible.
6. Have the client sign a release of information form for any doctors, schools,
etc. from whom you will need to request information. The release must be
completed prior to obtaining the signature. Copies of all releases/requests sent
out should be retained in the case file.
(Revised 4/96)
3.02-2
7. When possible, have the client gather information from other agencies or
individuals.
8. Complete the Financial Summary.
9. To the extent additional data is necessary, arrange for diagnostic studies
(Section 3.03).
10. Set short term "homework" tasks for the client as appropriate given the reported impairment of the applicant, to expedite plan development and test motivation. Make the client aware of the 60 DAY requirement for an eligibility decision and, as appropriate, his/her responsibilities in helping to meet the requirement.
DOCUMENTATION:
Upon completion of the initial interview, document and date in an initial interview contact report the general topic areas listed above. This contact report must be comprehensive as it forms the initial conceptual base which directs the diagnostic study and planning.
(Revised 4/96)
3.03 PRELIMINARY ASSESSMENT 3.03-1
DEFINITION:
The term "preliminary assessment" means: A review of existing data and, when necessary, additional data to the extent needed to determine whether an individual is eligible for vocational rehabilitation services.
NOTE: When an Order of Selection is used, the client's assigned service
priority is determined during the preliminary assessment.
GENERAL REQUIREMENTS:
eligibility.
process (e.g., interpreter services for individuals who are deaf or hard of
hearing shall be provided).
should not result in unreasonable delays in eligibility determination.
FORWARD PLANNING:
All information obtained during the assessment process for determining eligibility becomes part of the assessment process for determining vocational rehabilitation needs for eligible clients. Much of the same information is relevant to both purposes, however, the information is approached differently. The counselor does a preliminary assessment of the information in order to determine eligibility and a comprehensive assessment of the information in order to determine vocational rehabilitation needs for eligible clients. In those cases where eligibility seems fairly certain, it is appropriate for the counselor and client to begin planning for IWRP development throughout the assessment process.
(Revised 4/96)
3.03-2
PROCEDURES FOR OBTAINING AND UTILIZING DIAGNOSTICS:
STEP: ACTION:
1. During the initial interview, have the client sign a separate request for
release of information for each individual or agency that may have
pertinent information.
2. Request information; note date requested; follow up regularly.
3. Discuss with the client why other diagnostics are needed. Purchase
additional diagnostics only if available information is insufficient to
determine eligibility.
4. Encourage the client to take responsibility for making appointments for
diagnostics where appropriate.
5. Send written authorization to vendor prior to provision of diagnostic
services.
6. Approve payment of invoice for diagnostics only after receipt of written
reports and review of charges.
7. Obtain consultation as appropriate.
8. Discuss results of diagnostics with the client.
9. Assess all information in relation to eligibility; explain eligibility
decision to client.
SCOPE OF DIAGNOSTIC STUDIES:
GUIDELINES:
1. Impairments (Section 4.02) must be substantiated in written form by an M.D., D.O., certified psychologist, optometrist, audiologist, or other professional licensed or certified in the diagnosis of the impairment.
(Revised 4/96)
3.03-3
2. If the impairment is stable and non-progressive, existing data is generally
sufficient for substantiating the impairment. Existing reports should be
utilized whenever possible, however, when the impairment is not stabilized or
is progressive, current reports should be obtained.
3. If existing reports are not available/sufficient, the client's own physician or
physician of choice should be utilized whenever possible. To the extent
necessary, additional data may be purchased for the purpose of further
defining functional limitations.
4. Determinations made by officials of other agencies, particularly education
officials, regarding whether an individual satisfies one or more factors relating
to whether an individual is an individual with a disability, shall be used to the
extent appropriate for making eligibility determinations.
5. An individual who has been determined to have a disabitity under the Social
Security Act shall be considered to have a physical or mental impairment
which for such individual constitutes or results in a substantial impediment to
employment.
6. Specialist exams should be utilized as appropriate. (See examples listed
below.)
VISUAL IMPAIRMENTS:
1. Ophthatmologist if eye disease or pathology is known or suspected;
2. Optometrist can be used for initial screening or for refraction errors.
HEARING IMPAIRMENTS:
1. Otolaryngologist (ENT) if on-going ear pathology is known or suspected;
2. Audiologist may be used for hearing evaluation.
LEARNING DISABILITY OR MENTAL RETARDATION:
1. Psychologist certified by the State Board of Psychological Examiners;
(Revised 4/96)
3.03-4
2. Clinical Psychologist under the State Personnel Board;
3. Educational Diagnostician certified by the State Department of Education.
4. Neuropsychologist when learning disability is questionable.
MENTAL OR EMOTIONAL DISORDERS:
1. Psychiatrist;
2. Psychologist certified by the State Board of Psychological Examiners; or
3. Clinical Psychologist under the State Personnel Board.
CAUTION: Clients must be informed that treatment resulting from an authorized diagnostic exam will not be approved for payment and that recommended treatment may be approved only after eligibility is determined and IWRP is developed.
OTHER DIAGNOSTICS:
Diagnostics needed to substantiate or clarify functional limitations related to eligibitity determination may be obtained, as appropriate, from individuals who are licensed or qualified according to statewide professional standards:
0 If a general medical examination is to be used to substantiate the existence of
an impairment or to appraise the current health status of the applicant, a
physician's assistant (PA) may be utilized, instead of a licensed physician. The
term physician's assistant means a skilled person certified by the New Mexico
Board of Medical Examiners as being qualified by academic and practical
training to provide patient services under the supervision and direction of the
licensed physician who is responsible for the performance of that assistant.
0 Speech, occupational or physical therapists;
? Vocational evaluators in private practice or in a facility;
0 Other facility specialists or agencies such as Employment Security office
testing, State Personnel tests, etc.;
(Revised 4/96)
3.03-5
0 Rehabilitation engineer to assess a client's potential to benefit from Rehabilitation engineering services;
0 Educational Diagnostician's reports, school transcripts, or other school records.
HOSPITALIZATION FOR DIAGNOSTIC PURPOSES:
If hospitalization is requested by a physician for the purpose of diagnostic study, medical and supervisory consultation shall be obtained.
COUNSELOR ASSESSMENT:
Counselor assessment is of primary importance during the "Preliminary Assessment". The focus should be on the total person and the factors that contribute positively or negatively to the client's vocational functioning. TO THE EXTENT NECESSARY TO DETERMINE ELIGIBILITY (Section 4.00), counselor assessment consists of:
1. Assessment-analysis of information obtained from the client. This
includes all areas covered in the initial interview, the application and
the financial summary.
2. Assessment-analysis of reports from other persons or agencies, such as
doctors, psychologists, facilities, previous employers or other assessment
analysis of information obtained from the administration of assessment
instruments.
(Revised 4/96)
4.00 ELIGIBILITY 4.00
4.01 BASIC REQUIREMENTS 4.01-1
OVERVIEW OF ELIGIBILITY:
This agency defines eligibility on the basis of two criteria which must be met in order to declare eligibility for VR services. The sections which follow explain each of the criteria and definitions necessary to their application.
DEFINITION OF ELIGIBLE CLIENT:
An applicant for VR services for whom all of the following criteria are met:
1. An individual who meets the definition of an individual with a disability, i.e.
a. has a physical or a mental impairment (Section 4.02);
b. which for the individual constitutes or results in a substantial
impediment to employment (Section 4.03); and,
c. can benefit in terms of an employment outcome from vocational
rehabilitation services (Section 4.04).
II. Vocational Rehabilitation services are required in order for the individual to prepare for, enter, engage in, or retain gainful employment (Section 4.05).
SOCIAL SECURITY PRESUMPTION:
An individual who has a disability as determined under Title II or XVI of the Social Security Act is considered to have a physical or mental impairment which constitutes or results in a substantial impediment to employment (the first two elements of the definition of an "individual with a disability") and to have a severe physical or mental impairment which seriously limits one or more functional capacities in terms of an employment outcome (the first element of the definition of an "individual with a severe disability").
(Revised 4/96)
4.01-2
GUIDELINES:
1. The VR counselor is responsible for making eligibility decisions.
2. Eligibility determinations are applied without regard to sex, race, age, creed,
color, national origin, type of disability, economic status or availability of
comparable services and benefits.
3. An individual must be physically available for services and living in New
Mexico. There is no residential time or legal proof requirement such as
drivers license, voting registration, etc.
4. An individual cannot be served by more than one state rehabilitation agency
at the same time. American Indians may be eligible for services under the
state vocational rehabilitation program and the American Indian vocational
rehabilitation program (Section 130) simultaneously, however, IWRP
development must be coordinated to assure appropriate use of comparable
benefits and non-duplication of services.
5. Legalized aliens may be eligible for VR services based on meeting agency
requirements.
6. Eligibility determinations must be made in a reasonable period of time, not to
exceed 60 days after the individual has submitted an application (02 status)
unless the client has been notified of exceptional and unforeseen circumstances
beyond the control of DVR and the client agrees that an extension of time is
warranted (THIS MUST BE DONE IN WRITING BY COMPLETING THE
60 DAY WAIVER FORM OR an extended evaluation is required.
PROCEDURES FOR ELIGIBILITY DETERMINATION:
STEP: ACTION:
1. Make a separate determination for each of the eligibility criteria as to whether the client meets the criteria, based on an analysis of all information obtained during the diagnostic study.
2. Document the basis for severely disabled coding on Statement of
Eligibility.
(Revised 4/96)
4.01-3
3. Discuss the decision with the client.
4. Complete the Statement of Eligibility, sign and date the Statement, even
if the client is ineligible. (See Section 4.06)
NOTE: As the emphasis is on making an eligibility decision in a timely manner,
it is important that the client is aware that the eligibility decision does
not answer the question "eligible for what". Be sure that the client
understands that, in most instances, this will be determined in the
thorough diagnostic/plan development phase - Status 10.
Revised 4/96)
4.02-1
4.02 PHYSICAL OR MENTAL IMPAIRMENT
AND FUNCTIONAL LIMITATIONS
Eligibility for services requires that an individual meets the definition of an individual with a disability. The first part of this definition requires the presence of a physical or mental impairment.
DEFINITIONS:
PHYSICAL OR MENTAL IMPAIRMENT:
A physical or mental condition which substantially contributes to limiting, or if not corrected will probably result in limiting, an individual's functioning.
SUBSTANTIALLY LIMITS:
In relation to the impairment, having a substantial consequence that is not temporary or easily ameliorated.
TEMPORARY OR EASILY AMELIORATED:
Of no permanent or chronic consequence; a condition which is expected to last for a limited time only or to be corrected, either partially or totally, by an identified treatment, with little or no residual effects on functioning; an impairment for which the only service needed is payment of medical expenses.
FUNCTIONAL LIMTATIONS:
Limitations imposed by an impairment that impede or limit an individual's functioning in one or more of the following areas (or in any area of physical or mental functioning):
Sensory Functioning Work Habits
Manual Dexterity Personal Behavior
Motor Coordination Academic Achievement
Physical Strength or Stamina Interpersonal Relations
Mobility Job Seeking Skills
Physical Appearance Communication
Physical or Mental Comfort Speech
Thought Processes Perception
Learning Judgment
Emotional Stability Memory
(Revised 10/97)
4.02-2
BASIS FOR DETERMINATION:
To make a determination that there exists a physical or mental impairment there must be:
1. Data substantiating the existence of an impairment, as per Section 3.03;
2. Functional limitations evidenced by the counselor or stated in medical, psychological,
school or work records, or other sources.
GUIDELINES:
1. Counselor judgment is a critical factor in all issues of eligibility, particularly
in determining the types of diagnostics necessary to determine eligibility and
the best resources available for those diagnostics. Cost, quality, timeliness
and convenience must all be considered.
2. Psychological reports used to substantiate mental impairments should have a
DSM IV-R diagnosis. By definition, almost any condition that warrants a
DSM IV-R diagnosis is an impairment, except for diagnosis with "V" codes.
3. Functional limitations may be substantiated by medical or psychological
reports, school or work records or other information, but are primarily
documented by the counselor. This can be done by observation, talking with
the client, friend, or family or assessment results.
4. If presence of an impairment is questionable, the impairment should be
substantiated prior to the scheduling of other diagnostics not related to the
existence of an impairment.
5. At any time that a secondary impairment is suggested by an outside source,
the client, or suspected by the counselor, it should be explored to the extent
necessary to determine functional limitations.
(Revised 10/97)
4.02-3
SURGERY OR SHORT TERM MEDICAL TREATMENT:
Cases involving surgery or specific short term medical or dental treatment are generally not eligible if the surgery is expected to correct the condition with little or no residual effects. The existence of a medical problem, regardless of the immediate or current effect, is not necessarily an impairment. Even if the situation is critical, there must still be a need for other VR services, including counseling.
Examples:
a. The client has a thyroid tumor requiring surgery. The thyroid has been
imbalanced for so long that client has experienced a great deal of emotional
stress and anxiety, causing loss of work, self-confidence, and positive social.
relationships. The client is eligible because although the surgery will correct
the impairment, it will not alleviate the chronic functional limitations
imposed by the impairment.
b. The client has a chronically poor dental condition resulting in unsightly
appearance, pain and potential health hazard. Dental report indicates need
for extraction of remaining teeth and provision of dentures which will
alleviate all symptoms. The client is not eligible as client has an impairment,
but it is easily ameliorated (no residual effects expected), therefore, it is not
a disability. It is a medical problem requiring treatment, but not requiring
the services of a vocational rehabilitation counselor.
IMPAIRMENTS IN REMISSION:
Clients with chronic impairments which are currently in remission (multiple sclerosis, cancer) are considered to be disabled if the impairment has created functional limitations, or, if without treatment the impairment may become active again. The other eligibility criteria still must be met.
DOCUMENTATION:
A listing of impairment codes and diagnosis plus- an explanation of functional limitations must be included on the Statement of Eligibility.
(Revised 10/97)
4.03 SUBSTANTIAL IMPEDIMENT TO EMPLOYMENT: 4.03-1
Eligibility for VR services next requires "the presence of a physical or mental impairment which for the individual constitutes or results in a substantial impediment to employment".
DEFINITIONS:
SUBSTANTIAL IMPEDIMENT TO EMPLOYMENT:
A physical or mental impairment (Section 4.02), in light of attendant medical, psychological, vocational, educational and other related factors that impedes an individual's occupational performance by preventing their obtaining, retaining or preparing for employment consistent with the individual's capacities and abilities.
A substantial impediment may exist, for a number of reasons, including the following:
(Revised 10/97)
4.03-2
a. Aggravate the present mental or physical condition.
b. Create a hazard to the future health and safety of the individual.
C. Jeopardize the health and safety of others.
Some of the enviromenental factors that affect employment are: marketable skills; educational level; community and employer attitude concerning disability; long term unemployment; work record; attitudes toward work, family and community; and labor market.
EMPLOYMENT:
Full-time or as appropriate part-time employment consistent with the capacity and abilities of the individual in the competitive labor market; the practice of a profession; self-employment; homemaking; farm or family work (including work for which payment is in-kind rather than in cash); extended employment; homebased employment; supported employment or other gainful work (Section 13.00 and Section 14.00).
CONSISTENT WITH CAPACITIES AND ABILITIES:
Work which is not precluded by the disability; will not exacerbate the condition; and work which is neither significantly above nor below the individual's mental or physical abilities or aptitudes (not solely determined by eamings or income level).
(Revised 10/97)
4.03-3
BASIS FOR DETERMINATION:
In making a determination of a substantial impediment to employment, there must be:
GUIDELINES:
between functional limitations and vocational performance, and may include:
(Revised 10/97)
4.03-4
CLIENTS WHO ARE CURRENTLY WORKING:
A client who is working may have a substantial impediment to employment if the:
Clients who appear to have adequate job skills (includes transferable skills) to enter employment consistent with their capacities and aptitude may still have a substantial impediment to employment if:
EXAMPLES:
Two clients (X and Y), both left AK amputees, apply for services; medical reports indicate the same impairment and similar functional limitations. Both are unemployed.
(Revised 10/97)
4.03-5
Client X is considered well adjusted, has a B.A. in Accounting, and was a CPA for 15 years until he was laid off last month during a reduction in force. Client has no substantial impediment to employment as the reason for his unemployment is not related to his impairment.
Client Y was a lumberjack with an 8th grade education until a year ago when he suffered an accident resulting in an amputation. He has experienced physical pain since the accident, as well as adjustment problems, and has never returned to work. There does exist a substantial impediment to employment.
Attendant factors in both cases are psychological, vocational and educational. In the first case, all factors are positive, or strengths; in the second case they are contributing factors to the substantial impediment to employment.
DOCUMENTATION:
The substantial impediment to employment must be explained on the Statement of Eligibility.
Revised 10/97)
4.04 CAN BENEFIT IN TERMS OF AN
EMPLOYMENT OUTCOME
4.04-1
Eligibility for vocational rehabilitation services requires that the individual "can benefit in terms of an employment outcome from vocational rehabilitation services." It is presumed that an individual can benefit in terms of an employment outcome from vocational rehabilitation services unless the counselor can demonstrate clear and convincing evidence to the contrary.
DEFINITIONS:
PRESUMPTION OF BENEFIT:
It is presumed that an individual with a disability can benefit in terms of an employment outcome from vocational rehabilitation services unless the counselor can demonstrate by clear and convincing evidence to the contrary.
CAN BENEFIT:
A judgment by the counselor, based on interviews and other information, that through the provision of substantial VR services the client should be able to achieve an employment outcome. Keep in mind, you are making a decision as to the likelihood that a client can, not will, achieve an employment outcome.
Most clients can achieve an employment outcome but may not for reasons related to personal factors (motivation, etc.). When the decision centers mostly around personal factors, it becomes less likely that you will have clear and convincing evidence to support ineligibility. Under these circumstances proceed with regular services, giving the client the opportunity to demonstrate their willingness and ability to achieve an employment outcome - assuming all other eligibility criteria are met.
The counselor must have a general idea as to the type(s) of employment the client may be capable of achieving in order to certify that the client can benefit in terms of an employment outcome.
Prior to any determination that an individual with a severe disability is incapable of benefiting from VR services in terms of an employment outcome, because of the severity of the disability, the counselor must conduct an Extended Evaluation (06 status) to determine whether or not there is clear and convincing evidence.
(Revised 10/97)
4.04-2
EMPLOYMENT OUTCOME:
An individual entering or retaining full-time or, if appropriate, part-time competitive employment in the integrated labor market or satisfying any other vocational outcome. The following are considered suitable employment outcomes:
employment assessments, from service providers who have concluded that
they would be unable to meet the individual's needs due to the severity of the
individual's disability.
any necessary supports (including assistive technology), in real life settings.
(Revised 10/97)
4.04-3
UNAVAILABILITY OF SERVICES OR EMPLOYMENT:
DOCUMENTATION:
The counselor shall explain determination of "can benefit" in terms of an employment outcome on the Statement of Eligibility.
(Revised 10/97)
4.05-1
4.05 V.R. SERVICES REQUIRED
Eligibility for vocational rehabilitation services requires an individual to have a disability as defined in Section 4.01, and that services are required to prepare for, enter, engage in, or retain gainful employment.
REQUIRED SERVICES:
Services necessary to correct, modify, or circumvent the substantial impediment
(limitations or factors imposed by the impairment) which will contribute to the
client's achievement of an employment outcome.
An assessment whether services are required shall be based on the contributions of
these services to the client's ability to achieve an employment outcome.
BASIS FOR DETERMINATION:
In making a determination that VR services are required, the counselor must:
1. Determine what change(s) in the client's functioning is require , and
client's functioning and proposed service(s) - verify that without proposed
service(s), needed change(s) would.not occur, and
employment outcome.
Whether the service rendered or proposed to be rendered is "required" can best be determined by its contribution to the client's achievement of an employment outcome, not by such factors as a fixed number of services, expenditures, counseling hours, contacts with the client, etc., although such factors may serve as good indicators.
(Revised 10/97)
4.06 INELIGIBILITY 4.06-1
A client is ineligible for VR services, if the client does not meet, in the judgment of the counselor, one or more of the eligibility criteria.
BASIS FOR DETERMINATION:
Any of the following reasons may constitute the basis for a determination of
ineligibility:
NOTE: COUNSELOR MUST DEMONSTRATE BY CLEAR AND CONVINCING EVIDENCE THAT SUCH INDIVIDUALS ARE INCAPABLE OF BENEFITTING FROM VR SERVICES IN TERMS OF AN EMPLOYMENT OUTCOME.
If, for individuals who are severely disabled, the issue of whether or not the client can benefit is related to the severity of the impairment, the client must be placed into extended evaluation for further assessment to determine eligibility. If there is NO issue concerning severity, and clear and convincing evidence that the client cannot benefit is already on hand then the client may be closed 08 from 02 status.
(Revised 10/97)
4.06-2
GUIDELINES:
1. All determinations of ineligibility must be done in full consultation with the
client or, as appropriate, his/her parent, guardian or other representative, or
by documenting that a reasonable effort has been made to afford him/her an
opportunity for consultation prior to case closure.
2. The counselor must notify the client in writing of the determination that the
client is ineligible and of client's rights to seek remedy including the
procedure for review of the counselor's determination.
3. Referral should be made to other agencies or facilities as appropriate,
including Independent Living, and in all cases the client should be informed
of the availability of resources within the Client Assistance Program.
4. An ineligibility decision must be supported by clear documentation in the
case file.
5. Once a person has been certified as eligible, they may be decertified at any
point in the rehabilitation process, including after an IWRP for services has
been initiated, if the counselor determines that there no longer exists an
expectation that VR services may benefit the person in terms of an
employment outcome. The client may not be decertified for any other
reason.
REASONABLE EFFORT TO CONTACT:
Refer to Section 2.00-3 "Reasonable Effort to Contact"
CLOSURE DUE TO CLIENT UNAVAILABILITY:
A distinction must be made between ineligibility and unavailability. A person is only ineligible if they fail to meet one or more of the eligibility criteria; they are not necessarily ineligible if they are unavailable. A person is unavailable if the person has:
(Revised 10/97)
4.06-3
Clients who are unavailable should be closed as per Section 15.01.
ANNUAL REVIEW OF INELIGIBILITY DECISIONS:
1. When ineligibility is based on "cannot benefit in terms of an employment
outcome", the counselor must review the determination within 12 months of
the date that ineligibility was declared.
2. The purpose of the annual review is to review new information or changes in
circumstances that may affect the determination that the client "cannot
benefit in terms of an employment outcome". Reviews are made on an
individual basis with the client, his/her parent, guardian or other
representative who are offered a clear opportunity for full consultation.
3. Continuation of annual reviews of ineligibility determinations after the initial
annual review will occur only at the request of the client, his/her parent or
other representative. This may occur anytime after the initial review and
conditions applicable to the initial review will apply to additional reviews.
EXCLUSION:
Clients may be excluded from consultation concerning ineligibility, or from an annual review of ineligibility if:
(Revised 10/97)
4.06-4
DOCUMENTATION:
The reason(s) for a determination of ineligibility shall be fully explained on the Statement of Eligibility under the criteria that is not met. Efforts to inform the client must be documented in a contact report.
(Revised 10/97)
5.00 STATUS 06 - EXTENDED EVALUATION 5.00-1
Eligibility for extended evaluation is certified when:
1. There exists the presence of a severe physical or mental impairment;
2. which for the individual results in a substantial impediment to employment;
and
3. the counselor is unable to determine that the client can benefit from VR
services in terms of an employment outcome, but identifiable services
through a period of Extended Evaluation will enable the counselor to make
such a determination.
USE OF STATUS 06:
Extended Evaluation is used only:
1. To determine an individual's eligibility for VR services, with regard to whether the client can benefit in terms of an employment outcome, and
2. to determine the nature and scope of services required to achieve an employment outcome.
ONLY THOSE SERVICES WHICH ARE NECESSARY TO MAKE THESE TWO DETERMINATIONS CAN BE PROVIDED DURING THE EXTENDED EVALUATION PERIOD.
Extended evaluation is goal oriented. The counselor should have specific questions related to the individual's ability to benefit from VR services in terms of an employment outcome, for which the counselor is seeking answers.
The facility or persons providing extended evaluation services should be aware of these questions and what kind of information the counselor needs during the extended evaluation in order to make the eligibility decision. These questions, may be medical, psychological, educational, vocational, social, or personal, but relate to the reason(s) the counselor was unable to make the determination that the individual would benefit in terms of an employment outcome from VR services.
(Revised 10/97)
5.00-2
In keeping with a goal oriented approach to extended evaluation, it is important to consider that extended evaluation is not used to assess whether an individual can benefit from a specific service or services, but rather whether those services will enable the individual to actually become employed. Assessing whether an individual can successfully compete in a school program, for example, is not the end goal of extended evaluation. It may, however, be included as a service in the overall assessment of whether the individual can benefit in terms of an employment outcome.
The counselor may provide extended evaluation services to assess any of the following (partial list), each for the purpose of determining eligibility and the nature and scope of services required to achieve an employment outcome.
ASSESSMENT SERVICE
Physical Capacities Physical Capacities
Evaluation
Potential for improving Physical Therapy;
physical functioning Occupational Therapy;
Medical Treatment
Degree to which an unstable Medical Treatment;
or progressive condition may Hospitalization;
be stabilized Medication;
Medical Exams
Degree to which a psychological Psychotherapy;
disability may be improved by Counseling;
treatment Community Mental
Health Services
Ability to benefit from Short Term Vocational
training Training; OJT; Work Adjustment
Training
Potential for improving serious Work Adjustment Training;
behavioral problems affecting Personal or Social Adjustment;
employment Psychotherapy;
Counseling; Community Me