files and pen

Application

This page is a comprehensive discussion of the application for vocational rehabilitation services, from the required orientation through eligibility determination and the IPE. Almost anything found in a consumer’s file is found here.

Orientation Requirement

Prior to completing an application, consumers will attend an orientation on-site at the project office. Orientation sessions are held every two weeks.

High school students who have attended an orientation at school may also attend the on-site orientation, but this is not a requirement, and they have the option of scheduling an appointment with  a counselor directly.

VR APPLICATION PROCESS:

Initial completion of application: During the initial meeting the counselor will cover the following information to assess if an application should be taken.

Eligibility Screening

1.           It is important to cover tribal affiliation and residency on or near the Spirit Lake Reservation, as persons not meeting these criteria are referred to State Rehabilitation.  If the applicant does not fit the criteria the counselor will provide the person with a state rehabilitation client assistance booklet and the name and telephone number of the State VR counselor for their area.  The Project counselor will allow the person to use the Project telephone to contact the state VR office to schedule an appointment, if desired.  The Project counselor will also send a written referral to the State VR office if the individual needing services approves of such an action.

2. What is the applicant’s perception of VR Services?  If the applicant does not have an accurate understanding of this, the counselor will explain VR eligibility criteria and services.  The applicant is always told of the availability/programmatic details of the State VR. 

3.           What are the client’s  disabilities and how do they limit or cause barriers toemployment?  If the client cannot describe how the disabilities limit his/her employment, the eligibility criteria is once again explained and he/she is asked if they understand that this criteria must be shown before they can be determined eligible for services.

In all cases everyone has the right to apply for services whether it appears they will be eligible or not.  During the intake interview, the counselor asks the client all the applications questions, and the counselor completes the application for signature by the client to insure the application is fully completed.  Applications are normally completed in-person either in the VR office or at the client’s  home.

Clients are discouraged from applying through the mail or taking the application home to complete as it may result in inadequate information provided or incomplete forms, which may cause a delay in the application process.

At the time of application, the following forms are explained:

  1. VR Application
  2. Financial Summary
  3. Releases of information are completed for all hospitals, doctors, clinics, psychologists, or other agencies that can provide the project with documentation  of disability and limitations to be used in determining eligibility.  It is explained to the client the reasons for requesting this information and how the information is to be used and explained to the client.  Releases are also completed for the medical consultant and Project evaluators, explanation of the functions and roles played by the professions in the project are given at this time.
  4. A Client Assistance Booklet is given to the client, explaining the steps to rehabilitation, services available, client rights and responsibilities, the state client assistance project, and the appeals process.  The client is given the choice of either having the counselor review this booklet with them or reviewing it on their own.

Once all the information necessary to begin the application process has been completed, the counselor will explain to the client the next step in the eligibility process as follows:

Following the receipt of the medical documentation of the disability, the medical records are reviewed with the project director to determine if the disability is a substantial barrier to employment.  It is also to be determined whether the VR services will benefit the client in terms of employment.  If the information reviewed is not sufficient for the project to determine eligibility, further evaluations may be necessary.  It is also explained that if the information requested is not received within three weeks, the project will contact the client and request the client to assist in obtaining the necessary documentation to determine eligibility.  It is very important that the initial contacts and the contact reports include all the information related to that particular consumer.

Once an application is on file that is satisfactorily completed and has the client and counselor’s signatures, the case enters application status.  These criteria should be noted in the contact report and the contact report ends with a notation in BOLD TYPE that the consumer has entered application status two.

The date of the completed signed application is entered into database as the date of referral and also as the date entering application.  If the reported disability and the initial by the referral are different from that of the referral source, it is changed at this time.  Other information known is entered into the database. 

 General Medical Information

Within five working days of receipt of application and the appropriate releases, letters (with copies of the release maintained in client file) are sent to all doctors, psychologists, hospitals, and/or other health professionals who were reported by the applicant to have recent medical information (within one year) regarding the reported disability.  

 FOLLOW-UP ON APPLICATION:

If after three weeks the requested medical information is not received, then the consumer will be requested to contact the office to ask that the medical office proceed with providing the requested information. The project office may also contact the medical office to answer any questions necessary to have the information provided to the Project.  If after three weeks of attempting to get information from medical offices, the information is still not received, then the client will be contacted regarding alternatives to get the necessary information.  Alternatives may include setting up new examinations to obtain necessary medical documentation at the project’s expense.

SPECIALIST EXAMINATION:

Medical examinations by specialists in recognized medical specialty fields are to be secured upon recommendation of the general medical examiner  or if counselor feels is based on application process.  Exceptions may be made when specific examinations are automatically required for the conditions listed below.  These may be obtained without prior recommendations of a physician.  Medical specialists’ examinations are to include laboratory tests, x-rays and other studies necessary to establish the diagnosis.  Specialists’ examinations are routinely required when the disabling condition is:

  1. Cardiovascular
  2. Psychiatric
  3. Neurological
  4. Orthopedic Musculoskeletal)
  5. Urological (Urinary tract and/or reproductive systems)
  6. Visual or
  7. Allergies and/or Asthma
  8. Mental Retardation
  9. Deafness
  10. Learning Disabilities

Additional specialists’ examinations (non-routine) should generally be obtained  when specified in the general medical examination  report.  

INDIVIDUALIZED PLAN OF EMPLOYMENT:

  1. The counselor and the consumer share a mutual responsibility for developing an IPE for Extended Evaluation, supported employment, or Regular Case Services. An IPE will be developed when the counselor and consumer have concluded the eligibility phase of the rehabilitative process and have jointly agreed to the services. The IPE documents this agreement and clearly outlinesthe responsibilities of both the counselor and the consumer. The agreement takes into account  all the resources that mat be available in assisting the client to meet his goals and does not focus all responsibility on the Project’s resources.
  2. There must be rapport and open communication between the counselor and the consumer during the planning phase of the rehabilitative process to allow the freedom  to express ideas, interests  and concerns regarding potential rehabilitative services and objectives.
  3. The consumer’s functional limitations must remain in the forefront throughout the planning process. It may become necessary at times during the planning  phase for the counselor to explain some of the physical, mental, or emotional aspects of the consumer’s impairment. Thorough counseling can help the individual understand problems or limitations associated with certain rehabilitative goals and objectives.
  4. The initial diagnostic and evaluation data starts the planning phase of the rehabilitative process.  The diagnostic and evaluation data, along with other case information, will provide the foundation for the IPE.
  5. Sharing certain diagnostic information with the consumer during the planning period may be necessary to facilitate understanding of various physical or vocational problems and limitations.  The counselor should only share information considered not harmful or distressing to the individual.  The counselor should disclose medical and psychological records to the consumer only under the guidelines regarding release and confidentiality of consumer records in the confidentiality section of this manual.

The counselor should seek consultation and guidance from the project director if the consumer demands to see medical or psychological records that may be harmful.  Specific information related to completing the IPE is found in the form section of this manual.

Upon completion of negotiations of the IPE the client enters extended evaluation or regular services dependent on which status the client is found eligible.  An appropriate notation in bold print following the contact report indicating the completion of the IPE development, will indicate that person has changed to one of the two status listed above.

If a consumer is closed prior to completion of the IPE, their closure type is recorded as 08 if they had been found eligible for extended evaluation services, and as 28/30 if they had been accepted for regular services.  Written notification with appeals procedures must be sent to the client upon closure.

EXTENDED EVALUATION SERVICES:

When a client is in extended evaluation services, an emphasis is placed on the evaluation of the consumer’s potential to achieve a vocational goal.  Some of the common service evaluations are vocational, psychological, physical therapy, and occupational therapy. Some evaluations and training experiences may be allowed in extended evince, such as a quarter of academic training to determine if educational training is appropriate for a client.  A period of “work experience” may be tried to see if the client is capable of functioning in a work setting.  The development of a vocational goal that is compared with the consumer interests and capabilities and the development of an IPE for regular services are always intermediate objectives of an Extended Evaluation IPE.  Counseling is always a service provided during extended evaluation.

The Extended Evaluation IPE is reviewed every three months with the client to determine if there is obstacles to progress that may need to be dealt with.   If the client is not available at six-month intervals or does not cooperate in attempts to review the IPE, then it is very important that the counselor attempts to conduct the review.  If the review cannot be completed within one month of the review due date, then the Project Director is to be informed an appropriate decision made in regard to handling the situation.  Closing the case is an option that will be considered dependent on the circumstances.

Extended evaluation is always time-limited to 18 months.  If  the consumer and counselor cannot identify a reasonable vocational objective within that time frame, the case is closed as a 08 closure and the client is informed of ineligibility in writing (including an explanation of the appeals process).  The ineligibility is the lack of reasonable expectations that services can assist the consumer in achieving a vocational objective.  If the counselor comes to the conclusion that there is no possibility of services assisting the consumer in achieving a vocational objective prior to the end of eighteen months, the case is closed and the client is notified of the closure in writing.  If a client is closed in this manner, they have the right to reapply for services at any time in the future.  In making future eligibility decisions, the issue of what has changed to increase the possibility of the applicant benefiting from services will be a critical issue in determining eligibility.

If at any time in the eighteen-month extended evaluation period a suitable vocational objective and regular service IPE is developed and agreed upon, then the case is moved to regular services.  A notation in bold type following the contact report indicating the completion of a service IPE will indicate that the person has moved to services status.

Services Needed

The focus of activities during service status is fulfilling the commitments of the IPE. Review of the progress of the case related to the IPE will be conducted at least every three months.  Follow-up on difficulty in arranging reviews is the same as indicated in the extended evaluation section.

Services generally fall in the following categories:

  1. Counseling and Guidance-this is an ongoing service. The focus is on assisting the client in vocational development, self­ understanding, self -esteem, and adjustment issues.  However, the overall scope of counseling is not limited.  It should be noted that if a counselor feels that a consumer has counseling needs beyond the VR counselor’s range of counseling abilities, there should be no hesitation in assisting the consumer in making the necessary arrangements to have their counseling needs met.
  2. Job Placement– the counselor will identifY the activities to be provided by the agency or involved others regarding job placement assistance. These services are usually developed when the consumer is job ready.
  1. Physical and Mental Restoration – this includes medical and medically-related services which are necessary to correct or substantially modifY a physical or mental condition.  This category usually includes activities such as treatment, therapy, and assistive devices.
  2. Training and Training Materials- includes college, technical training, and on the job training (with related materials). 
  3. Maintenanceand Transportation   – included in this category are services necessary to cover basic living expenses to allow the consumer to complete the necessary objectives of the IPE. Consumer resources and other resources are explored carefully before allowing maintenance services.  Transportation needs related to rehabilitation objectives can be provided if there is evidence of financial need.
  4. Occupational Tools and Equipment- can be available if a placement has been definitely established and the equipment is necessary for employment. Assistance in this category is also available related to self-employment if a thorough feasibility study of success of the business has been completed and the equipment is necessary for startup.  If a person requires start up expenses that would in most cases be handled by a loan, rather than direct purchase, then a loan will need to be utilized for start up expenses rather than project services.
  5. Evaluations- evaluations  may be medical, vocational, psychological, or social in nature.  Most evaluations are performed during the application or extended evaluation status, but on occasion they are necessary in completing regular services.
  6. Other- other types of supportive activities may be provided at times, however, it is very important to remember that services must be related to the vocational goal. Therefore, “other” is not to be considered a wide-ranging open-ended category. It represents an allowable amount of flexibility that is to be used with justifiable discretion.

IPE amendments can be developed at any time during services or extended evaluation to make adjustments for changing circumstances  in the progress toward the vocational goal. The changes must be made with mutual agreement of the parties involved and the justification for changes must be recorded in the case record.

A consumer moves to placement status when they have achieved a position that is comparable to the Vocational Goal of the latest IPE or IPE Amendment.  The contact report related to placement should indicate the type of work, supervisor, and wages related to employment (to be stated on a per week basis), and stipulations related to maintaining employment.  A notation of placement status movement follows the contact report, which is in bold print.  

SUBSEQUENT CONTACT MEMOS

All counseling sessions must be reported as contact reports.  The diary approach will be used to reflect progressive narrative in all cases. The contact memo will show the dates of every contact or attempted contact to depict continuity of case activity and to avoid disjointed or fragmented narrative.  The diary approach indicates who is initiating contacts and it allows a clearer perspective on progress needs and problems encountered, also better establishes the degree of particular commitment to the rehabilitation process. This style of narrative clearly supports the counselor’s decision to either maintain case movement or to close the case.

Information Requirements

  • There must be a contact memo in all-open cases at least once every three (3) months.
  • Information entered should be concise and relevant.  Data found in other case reports should not be repeated unless such information is of significance to the contact reports.  All letters or other documents important to the understanding of the case should be referenced.
  • A contact report will be made each time that a consumer changes status. Justification of the change will be clearly and concisely provided at the end of such contact.   Changes in status will all be formatted: “Effective this date”, “consumer’s name”, “enter status category”.
  • The contact memo and IPE are separate documents and one does not substitute for the other.
  • Contact reports can be entered in legible long hand or typed. Preferably, handwritten entries should eventually be typed. 
  • The counselor signs or initials each Contact Report.

VR COUNSELOR’S STUDY OF THE APPLICANT:

The diagnostic study of each applicant is to be carried out to the degree necessary to determine eligibility and to constitute a basis for counseling.   It is to cover the basis areas significant in vocational planning, as outlined in the “Diagnostic Study Guide”.   The investigation is to include a complete medical record of the applicant’s physical, visual or mental disability.   Counselors can authorize general basic medical examinations and, where indicated, diagnostic specialist examinations for applicants. 

Important:  Except for diagnostic purposes, no medical or medically-related service can be provided until the case is accepted for extended evaluation or regular VR Services.

Qualifications , Time Line and Costs for Diagnostic Evaluations

MEDICAL CONSULTATION:

Counselors should not necessarily limit their consultative review on any applicant or consumer to one 1) initial review, while processing for eligibility status or for other VR services.

Duties of the Medical Consultant:

Medical consultation may be requested, but only the Project Director and Counselors  can determine eligibility for services.

Medical Examiners Qualifications

 Medical examiners-general and specialist.  All medical examiners must have a license to practice in the state where the service is  rendered.

FREEDOM OF CHOICE:

An applicant may choose to be examined by any physician having the above qualifications, providing the physician is willing to accept payment for these services in accordance with VR Medicaid Fee Schedule, and Medicaid, Medicare, and/or applicant’s / consumer’s medical insurance if these funding sources are involved. 

PSYCHOLOGIST QUALIFICATIONS:

Psychologists  who provide services to VR applicants must be licensed to practice in the state in which the service is rendered.  Psychologists  are exempt from licensing requirements when they are providing services as a part of their job.  Duties as a psychologist for any Federal, State, county or municipal agency, medical clinic organized as an unincorporated association, research laboratory, business corporation, or a duly­ chartered and accredited educational or charitable institution.

FUNCTIONAL LIMITATIONS:

In addition to establishing the diagnosis, all medical and/or psychological information should clearly indicate the nature and degree to which the applicant’s daily living and work activities are limited.  The reports are to include recommendations for treatment and a prognosis.

MEDICAL HISTORY:

Clinical summaries and abstracts obtained from records at schools, hospitals, institutions, clinics, doctor’s  offices, etc., are acceptable in lieu of new examinations, provided they are based on recent medical examinations and include sufficient pertinent medical data In some instances the counselor may be able to determine if such records are sufficiently recent and adequate in content; but when the counselor has doubts in this regard, advice of the Project Director will be sought.  Generally, records within 3 years would be acceptable.

TIME LINES:

Each applicant’s general basic medical or specialty examinations must have been completed during the past three (3) years.  The only exceptions are these listed below (1 and 2) or if in the opinion of the Project Director or Counselors, the existent medical evidence is suitable and sufficient.  The specialists’ examinations  completed prior to the applicant’s application for VR Services may be used to determine whether they provide adequate and current data.  

  1. On cases closed during the current or preceding fiscal year, new medical information will not be required if the physical impairments and general medical conditions have remained relatively stable, provided the information in the case record is acceptable to the Project Director or Counselor as described above.
  2. In those cases accepted from state hospitals, state schools, and correctional institutions, it is to be presumed that the referred individual was given a thorough physical examination on admission to the institution.  It is further to be presumed that the consumer has been under close supervision and that any significant change in health status has been noted.  Therefore, the general medical information supplied by the institution may be considered current unless, in the opinion of the counselor and/or the information is required.

NOTE:  The application process should reveal the medical conditions and medical need(s), including the necessity, for medical emergencies that may require invoking emergency procedures.  Should the applicant report a medical emergency, every effort will be made to expedite the medical exam and report process so that the applicant can be notified on a timely basis if the VR eligibility criteria are met or if VR will be involved in sponsoring costs.

DIAGNOSTIC COSTS:

Each diagnostic examination (which could include X-rays, lab work, hospitalization, etc.), that is necessary to establish medical eligibility for VR costing more than $200.00 requires preapproval  by Project Director or Counselor prior to authorization and provision of the service.  

Counselors are authorized to secure additional examinations after services have been initiated when conditions arise that may jeopardize the IPE (EXAMPLE:  examination for glasses, hearing evaluations, psychological  tests, etc.)  Consultation with the Project director or a medical professional would be in order if the counselor wishes further information on how to best manage the consumer’s future when new significant medical conditions develop that may require a change of the IPE.

DIAGNOSTIC HOSPITALIZATION:

Applicants may be hospitalized for diagnostic services if preliminary medical study indicates that such hospitalization  is necessary for adequate diagnostic study.

  1. Hospitalization for this purpose is not to exceed seven (7) days without written approval from the Project Director.
  2. Economicneed test is not applicable to the purchase of hospitalization  for diagnostic services, but all insurance and/or other resources will be utilized when available.

ADDITIONAL DIAGNOSTIC:

Diagnostic services, other than for the purposes of establishing eligibility, may be provided at any time during the rehabilitation  process without change of status.  When the diagnostic services required are extensive in nature or result in an interruption of the IPE, the case must be placed into services interrupted status.

It is not within the scope of vocational rehabilitation to provide for prenatal care, deliver (natural or surgical, or postnatal care) even though the counselor might be working with pregnant applicants.

VOCATIONAL IMPEDIMENT

INVESTIGATION TO ESTABLISH APPLICANT’S VOCATIONAL ASSETS AND LIABILITIES:

These investigations must include a sufficient study of applicant’s vocational assets and liabilities to evaluate the extent of the vocational handicaps and to provide a basis for establishing an applicant’s IPE. The counselor is review:

  1. Applicant’s employment records to determine the types of jobs, degrees of skills, and levels of performance that have been the applicant’s established patterns of vocational activities.
  2. Applicant’s vocational records to identify types and amounts of occupational instruction the applicant has had and the degree of success in that training.
  3. Applicant’s stated vocational interests and aptitudes that indicate applicant’s vocational potential.
  4. The effects of the applicant’s limitations on the ability to perform usual occupational duties and to secure employment. In cases where there is no established vocational activity, this appraisal is to be made in te1ms of the applicant’s abilities to secure employment consistent with his/her potentials.

Educational, psychological and personal adjustment assessment

EDUCATIONAL ACHIEVEMENT/PSYCHOLOGICAL FUNCTIONING:

The educational achievement and psychological functioning of the applicant is another significant area that is to be investigated.  The educational level achieved by each applicant is to be noted.  School transcripts should be used as key indicators of intellectual and learning abilities.  When educational problems are observed, appropriate testing should be secured.

  1. The educational records of those persons who have achieved any substantial degree of education are to be obtained and reviewed in an effort to identifY any special achievements that might be occupationally significant. When an applicant has obtained a high school diploma or attempted a business, technical or academic college, a transcript will be obtained.
  2. Whenever it is determined that a disabled person has a difficult or complex vocational problem, appropriate objective psychological information concerning aptitudes, interests, mental capacities and emotional stability is to be secured.

      a.  Counselors are to administer secure, as appropriate basic batteries of widely used standardized tests.

      b.  When available, such psychological information concerning the applicant is to be secured from school clinic community agencies and public/private institutions.

      c.  As necessary, counselors are authorized to purchase psychological studies from qualified specialists or institutions.

      d.  Counselors should guard against purchasing psychological tests that are not essential to establish eligibility or to aid planning.

PERSONAL ADJUSTMENTS:

An individual’s personal and social adjustment is vitally significant to his vocational adjustment.   This constitutes another basic area of investigation.

  1. In addition to objective psychological data, the information concerning a consumer is to include observed behavior, and an appraisal of his attitudes toward himself, his disability, and the social elements in his enviromnent.
  2. The degree and nature of acceptance of the applicant by the community in which he lives is to be identified and appraised as accurately as possible. 
  3. The sociological data is to include an accurate study and appraisal of the applicant’s home and family life.

ECONOMIC EVALUATION

The economic evaluation includes two components. First, does the the applicant him or herself have the financial ability to pay for these services. Second, can similar benefits be obtained from other programs.

The applicant’s economic situation is to be included in the planning process.  The counselor will insure that he has informed each applicant of the distinction between those services that are based on economic need and these services that may be provided at no cost to consumers.

SIMILAR BENEFITS

The applicant’s eligibility for “similar benefits” under other programs shall be part of the planning process.

“Similar Benefits” means any appropriate service or financial assistance available to an individual with a disability from a program other than vocational rehabilitation to meet, in whole or in part, the cost of vocational rehabilitation services to be provided under an individualized plan for employment (IPE) for such a handicapped individual.

1.  The counselor is to review with the applicant his eligibility for benefits from other agencies before committing agency funds.

2.  Similar benefits are to be utilized in all cases to the extent that they are adequate, timely, and do not interfere with achieving the rehabilitation objective of the applicant.

3.  Agency funds may be expended for training institutions of higher education only after maximum efforts have been made to obtain grant assistance from other sources.

  1. The IPE will identify the applicant’s eligibility for similar benefits and the extent and use of these benefits in achieving the vocational objective.

ELIGIBILITY REQUIREMENTS:

Introduction:

The VR Counselor is to secure the necessary information and apply the criteria for eligibility presented below and certify whether or not a person is eligible for vocational rehabilitation services.

There are two (2) basic criteria for eligibility that are inherent in the purpose and scope of the program and provided for in Federal and State law.   In addition, there are other specific criteria imposed by law and administrative decision.

First Basic Criterion is the presence of a physical or mental disability that constitutes or results in a substantial impediment to employment.

Physical or Mental Disability:

For purpose of eligibility, “disability” is defined as a physical or mental condition that materially limits, contributes to limiting, or, if not corrected, will probably result in limiting an individual’s activities or functioning.  The disability is to be evaluated through diagnostic study that is adequate to provide the basis for establishing that a physical or mental disability is present.

NOTE: A physician will make the diagnosis for mental or emotional disorders or by a psychologist licensed or certified in accordance with state law and regulations.  In all cases of mental retardation, a psychological evaluation is to be obtained.  In diagnosing disabilities found in the Diagnostic and Statistical Manual of Mental Disorders, a licensed practitioner should make the determination.

A proper medical diagnosis should be obtained if there is an indication that the etiology of the psychosis is organic. Examinations  by other specialists may be required.

SUBSTANTIAL IMPEDIMENT TO EMPLOYMENT:

The existence of physical or mental disability alone is not sufficient to establish eligibility.  The VR Counselor must also clearly determine and substantiate the existence of a handicap to employment.

a.  The presence of a substantial handicap exists when a disability significantly interferes with the opportunity for suitable employment.  It also exists when interfering with preparation for suitable employment, causes a loss of employment, causes the individual to require special assistance in securing suitable employment and/or when performing job duties.  The information gathered by the VR Counselor (i.e., educational background, previous work experience, medical and psychological information, etc.) must reflect that the individuals need for vocational rehabilitation services results, at least in part, from the disability.

b.  A disability may be an employment handicap in either of two ways: The employment handicap may be the direct result of the Disability and the employment handicap may be related to the disability in light of attendant medical, psychological, vocational, educational, or other environment factors. Examples of these factors are a lack of marketable work skills, low educational level, community and employer prejudices and attitudes concerning disability, long -term unemployment, unstable work record, ethnic group, poverty environment, long history of dependency, and poor attitudes toward work, family, and community.

c.  A substantial employment handicap may also exist when a disabled person is employed but whose job is wholly inconsistent with his abilities.  In some instances, this employment handicap provides the basis for vocational rehabilitation services to individuals with disabilities who are substantially unemployed. Their potentials, interests, and desires must be determined. Programs must be developed to help the reach suitable employment goals.  This policy does not mean that disabled people are to be found eligible simply to secure promotion.

SECOND BASIC CRITERION: A reasonable expectation  stating that vocational rehabilitation services will benefit the individual in terms of employability.

Employability- A reasonable expectation that vocational rehabilitation services will benefit the individual in terms of employability is a part of the eligibility requirement for each individual.  “Employability” refers to a determination that the provision of vocational rehabilitation services is likely to enable an individual to enter or retain employment consistent with his capacities and abilities in the competitive labor market; the practice of a profession, self- employment, homemaking, farm, or family work. This includes work for which payment is in kind rather that in cash, including also sheltered employment; homebound employment or other gainful work.

An individual’s potential for employment must be evaluated by considering the effect that the vocational rehabilitation services will have on reducing or correcting the disability, or on lessening the employment handicap and providing greater opportunity for employment. The extent of the evaluation may vary greatly from one individual to another, depending on the nature and severity of the problem.  For example, counselor judgment base on an interview, referral data, or medical examinations may be sufficient to determine the rehabilitation potential in some cases.

In other cases, more formal evaluations procedures, such as vocational evaluation in a rehabilitation  facility, may be necessary.  In other cases, the use of the extended evaluation process may be necessary in order to make a valid determination of rehabilitation  potential.  

NOTE:  The VR counselor should not let an anticipated low-wage employment placement influence the counselor’s decision not to provide rehabilitation services to a particular applicant.  There are numerous instances where the applicant has limited potential for competitive jobs at or above the federal minimum wage, yet the applicant remains a viable candidate for VR services to optimize personal and vocational potential.

Services Outside Project-As a general policy, the Project will not pay for services provided outside North Dakota.

EXCEPTION:   Services may be provided outside the state when appropriate services are not available in the state or when it is in the best interest of the consumer and the Project to secure services outside the state.  Rates of payment will be that of the state in which the services are provided.

CERTIFICATION OF ELIGIBILITY

CERTIFICATION OF ELIGIBILITY FOR VOCATIONAL REHABILITATION SERVICES OR FOR EXTENDED EVALUATION SERVICES:

The Counselor is required to complete and mail a letter of eligibility determination.

Since the purpose of the provision of vocational rehabilitation services is to enable consumers to prepare for and engage in gainful employment, a preliminary diagnostic study must document

(a) The presence of the medically recognized physical or mental disability;

(b) how the identified disability is substantially handicapping to that consumer; and

(c) the consumer’s potential to enter gainful employment as a result of vocational rehabilitation services.  

All points, (a),  (b), and (c), must be documented or the diagnostic study would not place primary emphasis upon the consumer’s potential for achieving a vocational goal.

a.  As a minimum, the “Diagnostic Study” consists of eight (8) fundamental headings and multiple subheadings of information. In general, this data is derived from the consumer and collateral sources such as medical and psychological practitioners, schools and colleges, family members and employers, and meeting with the medical consultant. Realistic planning can emerge only when the data is appraised.

b.  The vocational handicap, in particular, is an analysis showing the specific ways in which medical, psychological, vocational, educational, cultural, social, or environmental  factors impede the individual’s occupational performance by preventing the consumer from obtaining, retaining, or preparing for employment consistent with identified capacities and abilities.

c.  The Project Director may expand the Diagnostic Study Guide to the most comprehensive degree preferred, provided the recording is relevant to, and assists with, the planning process.

d.  The following guide will be used in developing diagnostic summaries.

1. DIAGNOSIS:

2. VOCATIONAL IMPEDIMENT:

3. WORK EXPERIENCE: 

4. EDUCATIONAL BACKGROUND:

5. PERSONAL & SOCIAL ADJUSTMENT:

  1. POTENTIAL FOR EMPLOYMENT:
  2. PLANNING:
  3. CERTIFICATION: Letter of Eligibility

IPE FORM COMPLETION:

COMPLETING THE IPE FOR REGULAR  SERVICES:

Original Program-The counselor will complete an IPE for Regular Case Services or Extended Evaluation when the planning phase is concluded and the counselor and consumer are in agreement.  The counselor, consumer and/or consumer’s representative will sign the completed IPE.  The counselor will retain the original copy of the IPE for the consumer’s file and a copy will be given to the consumer.

Amended Program-Any changes in the original program will require completion of an “amendment” to the IPE form.  The counselor will retain the original copy of the “amendment” IPE for the consumer’s file and a copy will be given to the applicant.

The counselor will complete the IPE for Extended Evaluation Services when existing diagnostic information is inadequate and the counselor is unable to determine the applicant’s rehabilitation potential.  An IPE will be initiated for at least guidance and counseling.  The counselor will retain the signed original copy of the IPE for theapplicant’s file and a copy will be given to the applicant. 

When moving a consumer from Extended Evaluation to Regular Service Status, the counselor will complete the IPE Amendment, and a new IPE.

IPE Amendment- Instructions for Completing Form IPE:

  1. Enter the consumer’s full name (last name, first, middle).
  2. Enter consumer number, phone number, address, and status.

VOCATIONAL GOAL: LONG RANGE VOCATIONAL OBJECTIVE:

This entry is to identify the vocational objective developed through joint planning by the counselor and consumer. 

  1. Enter the specific Vocational objective by job title.  One of the principle functions of the amendment is to change the goal based on the most current data.  Goal changes should be viewed as a positive indicator, providing the counselor offers a written explanation.  If essential, a vocational evaluation can be obtained in the extended evaluation.  Substitute  “Extended Evaluation” for the goal.
  2. Enter the predicted date of goal completion.
  3. Enter an explanation of how the counselor and the consumer have determined that the goal selected is appropriate; identify tests, vocational evaluations, capacity assessments, and other services assisted in goal selection.
  4. Enter completion date of services.

INTERMEDIATE REHABILITATION OBJECTIVES:

This entry will identify the intermediate objectives of the IPE chronologically, including the beginning and ending dates.  These objectives will be intermediate levels of skills, competence, and/or physical abilities that the consumer must achieve in order to reach the vocational goal.  (See pages 11-15 for completed example of IPE.)

Example 1:  Stabilization or correction of a medical or psychological condition which will allow the consumer to pursue a vocational goal.

Example 2:  Achievement of GED certificate prior to acceptance for vocational or academic training activities.

Example 3:  Obtain skills that pertain to the use of medical or other assistant devices.  This will enable the consumer to enter into training, then possibly employment.

Example 4:  Obtaining a specified grade average…or skill level on a trial basis.

Example 5:      Reaching a necessary level of behavioral modification, work behaviors, job interviewing skills, etc.

PLANNED SERVICES:

Listed below are the major rehabilitative service captions that are to be recorded in this section of the IPE.  When services are provided at no cost to the agency, enter “No Cost” under their estimated cost column.  Check all of the funding boxes that apply.  Each service should be listed specifically and chronologically. The counselor must mention the vendor(s), location of service(s), beginning and ending dates of services at least yearly and if the exact cost proves to be illusive, the counselor may use estimation.  Actual costs will be entered at quarterly reviews and summary total of costs will be entered at quarterly review.

1.  Counseling and Guidance– The service is checked in all cases.

If another counselor is to perform a part of this service, enter the counselor’s name and District Office.  Enter a “check” in this box and the beginning and ending dated for the duration of services.

  1. JobPlacement-The counselor will identify the activities to be provided by the agency or others involved regarding job placement assistance.  Every case in placement should contain a placement plan that outlines in sequential order the VR efforts to ensure a successful placement.  The IPE Amendment will be used as a placement plan or the placement plan can be incorporated in the original plan at a quarterly review.
  2. Physical and Mental Restoration– If this category of services is planned for the consumer, enter the nature of the service.

Example: Bilateral Hernia repair.

  1. Prosthetic Appliances– If a prosthetic or orthotic device is to be furnished to the client, enter the type of appliance.
  2. Training and Training Materials– Enter vendor, type of training, location, costs, etc.
  3. Maintenanceand Transportation — If this service is to be provided, enter the reason for it.  If maintenance is needed, enter the length of time the maintenance is to be received, the starting date, and the monthly amount.  Also, give a break down of the various maintenance costs involved.

7.  Occupational Tools and Equipment– Enter the type of occupational tools and equipment to be provided. Examples: welding tools, auto mechanic tools, and other equipment.  (This category is subject to project purchasing procedures, depending on the cost.  The consumer should be aware that vendor selection is not always consumer or counselor prerogative.)

8.  Evaluation in Rehabilitative Facility or Workshop -All evaluation services purchased from a workshop or a rehabilitative facility are to be mentioned.

9.  Recruitment and Training Services for appropriate public service employment — In this item, the counselor will identify the nature of training and kind of Public Service Employment. Rehabilitation  Engineering  — Check the box and provide comments, if appropriate.

10.  Other  — Enter here only those service which cannot be classified under the previous headings.

11.  Assessment of Anticipated Post Employment Services — provide comments, if appropriate.

SIMILAR BENEFITS:

This section will identify all comparable benefits presently available to the consumer. The counselor needs to show the comparable benefits that may be potentially available to the consumer.  If comparable benefits are exhausted and none are available, the counselor must clearly state this factor.

CONSUMER AND VR COST PARTICIPATION AGREEMENT:

Enter the consumer’s total cost contribution to the VR process.  The consumer’s contribution should be itemized.  The counselor will show what specific service costs that the VR is sponsoring.  The counselor also needs to indicate the specific contributions of any involved third parties, WCD, SSA self-support plans, PELL, JTPA, other loans, settlements, etc.   This category must illustrate how living, transportation, and service costs are being met.

POSSIBLE CONTINGENCIES/ ALTERNATIVES/COUNSELOR COMMENTS

 In this section, the counselor will record any potential complications to the VR plan of services and indicate possible alternatives in the event that complications do arise.   In addition, the counselor may want to make certain comments in this section that seem necessary for better consumer understanding of the VR program.

SIGNATURES REQUIRED

The IPE requires the consumer, counselors signatures, as well as the date that the IPE is completed and signed.  

REVIEW AND EVALUATION OF PROGRESS TOWARD  OBJECTIVES AND GOALS:

This entry will explain how the counselor will evaluate the consumer’s progress toward IPE and his/her completion of the goals/objectives.

Example:

The consumer in academic training is evaluated on the basis of quarter or semester grades, hours successfully completed, etc. The consumer in vocational training is evaluated on the basis of monthly training progress reports, including regular attendance. The consumer receiving physical and mental restoration services is evaluated according to medical progress reports.   The counselor needs to mention what the frequency of progress evaluation is for each method of measurement.

PURPOSE OF FINANCIAL NEED STANDARD:

The financial need standard provides a formula and certain values by which VR may determine the existence and extent of an individual’s financial need.

ACQUISTION OF ECONOMIC DATA:

  1. Total consumer income, financial obligations and economic need for services will be determined prior to IPE development.
  2. The Financial Form will be in the consumer file every twelve (12) months while the case is in open status.
  1. When VR “Cost Services” are entailed, the Financial Form must reflect the consumer’s full financial assessment, analysis and signature. Refusal to divulge financial disclosure constitutes consumer failure to cooperate and “Cost Services” are immediately terminated.  “No Cost” services may still be provided.
  2. Income surplus or deficiencies require explanation. If deficiencies exist, show how much of it will be the consumer’s contribution toward the cost of rehabilitation.
  3. Counselors should attempt to collect financial data on “No Cost” service cases. If this is not possible, the RSN5-2 should contain a statement proclaiming “No Cost” services only and that financial disclosure is not required.
  4. The financial status of the client will be reviewed annually at IPE reviews  and if there are changes of more than 10% in a consumer’s income or expenditures a new financial form will be completed.

If it becomes necessary for the consumer to relocate in order to secure vocational training.

Example —  Guidance and counseling may be provided to one or more family members if necessary.  The agency endorses the holistic approach to rehabilitation.  Disharmony in the family unit can have a direct and deleterious impact on the rehabilitation  outcome.  Job placement and job retention can be seriously jeopardized unless the family satellite is stabilized to the optimum degree.

Example–   To undergo certain VR services it may be necessary for a family member, acting in the capacity of an attendant, to accompany the consumer

SERVICES TO GROUPS OF INDIVIDUALS WITH DISABILITIES

Services, facilitates, equipment, and materials may be provided to a group of individuals with disabilities, some of whom are currently or potentially vocational rehabilitation consumers, if the services, facilitates, equipment, and materials will contribute substantially to the rehabilitation of the group as a whole.  These services must benefit the group as a whole and not just one individual in the group.  All disability groups are eligible.

PRIORITY OF FUNDING:

Due to financial limitations, preference will be given to services, facilities, equipment and materials with the potential for benefiting the largest number of persons with disabilities at a minimum cost to the project.  Funds for this program will be used to resolve a one-time problem such as the removal of architectural  barriers or the purchase of equipment.  The method of funding includes, but is not limited to, purchasing services, etc., through grant or contract.

WORKPLACE VIOLENCE AND REASONS FOR TERMINATION FROM PROJECT

WORKPLACE VIOLENCE

Workplace Violence means any situation that increases the intensity of employee relationships, threatens the safety of any employee, impacts any employee’s physical or psychological  well-being, and/or causes damage to the Department’s property.

Violent acts or threats of violence include any activity by an individual that would cause another individual to feel unsafe due to threat of inunediate physical harm. The violent behavior may take the form of verbal threats to harm another person or damage property, physical aggression, or harassment including sexual harassment. Threats of violence include possession or display of a weapon of any type or exhibiting an object in such a manner that it appears to be a weapon.

Abusive language, intimidation, threats, threatening behavior, sexual or other harassment, or acts of violence against fellow employees, consumers and visiting public, or property will not be tolerated within Spirit Lake Vocational Rehabilitation  Project.

Any employee may initiate a request for assistance from his/her supervisor, or law enforcement official, when all reasonable and conventional  approaches taken to control the actions of a visitor or other individual prove to be unsuccessful.

All employees are responsible for notifying their supervisor of any threats that they have witnessed, received or have been told that another person has witnessed or received. An Incident Report Form must be filled out.

Violations of this policy by employees will lead to disciplinary  action up to and including dismissal.

REASONS FOR TERMINATION FROM PROJECT:

  • In treatment
  • Incarceration
  • Missed ten appointments  within 60 days
  • Threatens staff with firearm
  • Physical abuse of staff
  • Based on negative drug and alcohol evaluation
  • Refusal to undergo recommended drug and alcohol evaluation
  • Substantial verbal abuse of staff (intensity, duration and frequency)- defined as threats or profanity

FOOD ORDERS & TEMPORARY HOUSING EXPENSES:

Native Healing

RELOCATION EXPENSES:

Moving expenses may be paid up to $1,000 under the following conditions: The consumer is accepted into an accredited higher education program. Financial aid from the institution is not sufficient to cover expenses.

Funds will be paid for mileage, moving vans, first month’s rent and utility hook-ups.

ORDER OF SELECTION

In the event that the project cannot serve all eligible consumers, an order of selection will be used where the most severely disabled consumers will be served first. The following order of selection will be used:

  1. Veterans with a severe disability.
  2. Other consumers with a severe disability.
  3. Veterans with a moderate disability.
  4. Other consumers with a moderate disability.
  5. Veterans with a mild disability.
  6. Other consumers with a mild disability.