Fill and Sign the Employment and Support Allowance Medical Report Form

GUIDE TO NEW HAMPSHIRE STATE VOCATIONAL REHABILITATION PROGRAM BY THE CLIENT ASSISTANCE PROGRAM NOVEMBER 2002 Acknowledgements The Client Assistance Program (CAP) would like to thank all those who helped develop the CAP Guide. Please let us know your thoughts and comments about this guide. This guide is not an official policy manual. Its purpose is to inform the applicants and customers of New Hampshire's Vocational Rehabilitation (VR) program about their rights and responsibilities as a VR customer. It is written to be useful regardless of future changes to regulations or state rules. Contact CAP or your VR counselor for more specific information or to review current policy, rules or federal regulations. For a copy of this Guide in an alternative format such as Braille, cassette tape, or computer diskette, please contact the Client Assistance Program. We are here to help you. 2 What is VR? The vocational rehabilitation (VR) program is one of the Nation’s oldest federal programs established by the Rehabilitation Act of 1973 (the Act). The VR program is also a full partner in the NH Works OneStop service delivery system. The mission of VR is to help people with disabilities prepare for, find and keep suitable employment. You will make “informed choices” during the VR process. VR will give you the information, assistance and support you need to understand how to make informed choice decisions. The VR choices you make at each step should be based on your informed choice and Vocational Rehabilitation requires your active involvement. What is Granite State Independent Living? Granite State Independent Living (GSIL) is a community-based organization. GSIL provides services and advocacy by and for persons with disabilities. Granite State Independent Living is non-profit and consumer-controlled. The goal of Independent Living is for individuals with disabilities to achieve their maximum potential within their families and communities. Independent Living Centers also work to assure access to housing, employment, transportation, communities, recreational facilities, and health and social services. 4 What is the Client Assistance Program (CAP)? The Client Assistance Program (CAP) is an advocacy program for persons with disabilities who are applicants or clients of Vocational Rehabilitation (VR) or Independent Living (IL) programs. CAP provides information on all services and benefits available under the Americans with Disabilities Act or Title I of the ADA to anyone. CAP targets its services and outreach to minorities and other unserved or underserved populations. CAP provides advocacy and a forum to air grievances for consumers of VR and IL services. CAP has the right to decide how to best serve the individuals who want CAP services. This means that CAP is not required to provide every service to every individual. CAP makes decisions after considering the facts and merits of each case, the needs of the client, and the available resources. Contact CAP if you want help with Vocational Rehabilitation or Independent Living services or benefits. All CAP services are free. 5 What is in this Guide? The guide contains general information about the Vocational Rehabilitation process, procedures and services to help you understand: • Eligibility for services • The VR process • Your rights as a consumer Who is this Guide for? This Guide is for people who: • Plan to apply for VR services • Are already VR customers • Are friends or relatives of VR customers • Are providing services to VR or VR customers • Are with agencies working with VR and VR customers 6 How can this Guide be used? • Review and read specific sections of the Guide that apply to you. • Use the DEFINITION OF TERMS to find the meanings of terms used such as INFORMED CHOICE. • If you have questions about anything in this Guide, contact: Client Assistance Program (CAP) 57 Regional Drive Concord, NH 03301 Toll-free at 1-800-852-3405 or (603) 271-2773 (Voice or TTY) or e-mail: bhagy@gov.state.nh.us CAP can provide free and confidential assistance, information, advice, investigation, mediation, and advocacy to VR applicants, customers, and their advocates. 7 State Vocational Rehabilitation Offices Vocational Rehabilitation has a Central Administrative Office in Concord and Regional Offices throughout the state. Listed in the back of the Guide are the locations and contact information for the NHVR Regional Offices. Contact the office closest to you for information on how to apply for services. You can also visit VR’s website for more information about VR. A copy of VR’s Policy Manual is available on their website. Vocational Rehabilitation Central Administrative Office 78 Regional Drive. Bldg. 2 Concord, NH 03301 271-3471 (Voice/TTY) 800-299-1647 (Toll Free/Voice/TTY) www.ed.state.nh.us/vr 8 NH Works VR services are provided through the NH Employment Security (NHES) Resource Centers, a part of NHWORKS. NHWORKS career center sites are listed in the back of this Guide. Visit NHWORKS website at: http://nhworks.org/ US Government Disability Information A Federal website of disability-related government resources is available online. This website provides information and links to information that you may find useful. Visit the Disability Information website online at: http://www.disabilityinfo.gov/ 9 GUIDE TO NEW HAMPSHIRE'S STATE VOCATIONAL REHABILITATION PROGRAM TABLE OF CONTENTS Are You Eligible? ...................................................................14 Eligibility Factors .......................................................................15 Ineligibility Factors.....................................................................18 Understanding the VR Process ............................................20 Status 00: Referral ....................................................................20 Status 02: Applicant..................................................................24 Assessments ............................................................................25 Status 06: Extended Evaluation ..................................................27 Status 08: Closure from previous statuses ...................................27 Status 10: Certified Eligible for Services ......................................29 Services ..................................................................................30 Limitations on Services.........................................................33 The Individualized Plan for Employment (IPE)....................34 Status 12: IPE Completed ..........................................................38 Status 14: Counseling and Guidance Only....................................39 Status 16: Physical or Mental Restoration: ...................................39 Status 18: Training....................................................................41 Status 20: Services Completed...................................................41 Status 22: Employed .................................................................41 Status 24: Services Interrupted...................................................42 Status 26: Successful Rehabilitation............................................42 Case closure...........................................................................43 Status 28: Closure After Services Begin ......................................44 Status 30: Closure Before Services Begin ....................................44 Status 32: Post-Employment Services .........................................44 Rehabilitation Technology ....................................................46 VR Sources of Qualified Personnel ..............................................47 Who Shall Pay?.........................................................................47 Who can help?..........................................................................49 Transition from School to Work ...........................................50 Supported Employment ........................................................52 Extended Supports ................................................................52 Independent Living Programs ..............................................55 Eligibility ..................................................................................55 12 Independent Living Services for Older Individuals Who are Blind .................................................................................................57 The Statewide Independent Living Council (SILC) .............58 Tips for Success ....................................................................59 State Rehabilitation Council (SRC) ......................................62 A Few Words About Money...................................................63 Benefits planning.......................................................................64 Your Rights as a Vocational Rehabilitation Customer .......67 Your Right to Appeal .................................................................68 The Appeals Process .................................................................69 Fair Hearings.............................................................................70 How The Client Assistance Program Can Help...................72 When VR must advise you Of the Client Assistance Program .........74 When to contact the Client Assistance Program ...........................75 DEFINITIONS OF TERMS.......................................................76 VOCATIONAL REHABILITATION REGIONAL OFFICES......90 NEW HAMPSHIRE ONE STOP CAREER CENTER SITES ...91 13 Are You Eligible? In New Hampshire, the Department of Education’s Division of Adult Learning and Rehabilitation provides Vocational Rehabilitation (VR) services to eligible individuals who want an employment outcome. The Bureau of Blind Services (SBVI) is part of VR. VR provides those eligible with a variety of choices to get and keep their chosen employment. VR programs support principles of respect, personal responsibility, self-determination, informed choice and active and full participation in the pursuit of meaningful careers. VR also supports involvement of families and advocates. VR may provide some services indirectly through various public and private agencies. VR supports all customers in the exercise of their informed choice including: 14 • Information and support necessary for you to make your own decisions throughout the VR process • Help in choosing what services you need • Information on qualifications of service providers • Flexibility in ways to get services • A well-documented case record of VR services Who is eligible? VR provides services without regard to race, language, gender, age, national origin, religion, disabling condition, marital status, type of employment, source of referral, particular service needs, or how much it will cost. There is no residence requirement based on how long you have lived in the state and no age limit for eligibility. Eligibility Factors You are presumed eligible for VR services if: • You have a physical or mental impairment that is an impediment to employment • You can benefit from VR services in terms of an employment outcome • You require VR services to get or keep gainful employment 15 • You qualify for or receive SSI and/or SSDI benefits • A VR Counselor determines you want and need VR services • You are a student in transition from school to work Employment Outcome "Employment Outcome" means getting and keeping fulltime or part-time work. Employment outcome includes the following vocational goals: • Competitive work in the integrated labor market • The practice of a profession • Self-employment • Telecommuting • Home-based employment • Homemaking • Farm or family work • Supported Employment • Other gainful work VR will presume you can benefit from VR services unless it has clear and convincing evidence that you cannot benefit from services in terms of an employment outcome. 16 VR must do a further study called an "extended evaluation" before finding you ineligible for services. There is no time limit for an extended evaluation. You must be willing to agree to and sign an extended evaluation plan. The extended evaluation may include trial work. Trial work experiences include supported employment, on-the-job training, and other experiences using realistic work settings. For more details about extended evaluation see Status 06: Extended Evaluation on page 27. 17 Ineligibility Factors You may be found ineligible for VR services after a full consultation with VR if: • Your disability does not result in a substantial impediment to employment, or • You do not require VR services to prepare for, enter, engage in, or retain gainful employment, or • After conducting an extended evaluation, your counselor finds clear and convincing evidence that you cannot benefit in terms of an employment outcome. VR has 60 days from the date your VR application is signed to determine if you are eligible. If VR decides that you are not eligible for services, they must notify you in writing or, if necessary, other appropriate mode of communication within 60 days from the date your application is signed. 18 The notice should give: • The reason you were found not eligible • Information about the Client Assistance Program and how to contact them • Information about your right to a review through an impartial due process hearing or voluntary mediation and how to request one • How to challenge any decision made by VR If you are found not to be eligible for services, VR should refer you to other programs that are part of the One-Stop service delivery system. 19 Understanding the VR Process You go through a number of steps in the VR process. VR uses a numbered system to track your progress in this process. This starts when you are referred for services. Each stage in the process is called a "status" and has a number. Changes to your status should always be documented in your file. You do not need to keep track of status numbers, but you may want to know what they mean. Following is an explanation. Status 00: Referral Someone referred to a VR office enters this status. Referrals to VR are placed in status 02 as soon as an application is completed and signed or services are requested. VR services can be requested verbally, by phone, fax, or e-mail. Whether referring yourself or someone else, try to provide the following information to VR when requesting services: • First and last name • Social Security number (if available) • Address • Date of birth • Sex • Disability • Phone number • Name of guardian or legal representative, if applicable Application Process VR should seek your informed choice from the beginning of the VR process. Informed choice allows you to participate in the VR process of planning, problem solving, decisionmaking and identifying needed resources. Informed choice requires that information in the VR process be clearly communicated and understood by all. If you need assistance with informed choice, VR should help you to get the kind and amount of assistance needed so you understand informed choice and how to exercise it. You should be able to understand all information you receive from VR. Be sure you have the appropriate support and assistance you need such as: • The skills and accommodations you need to exercise informed choice • Support and assistance of other individuals such as family or an advocate • Consumer empowerment training • The use of a self-discovery or self-management tool 21 When you request an application for VR services, you may be asked to attend an Orientation Session at your local VR office to learn about the VR program and procedures. VR will give you release of information forms to fill out to obtain your personal information and to describe your current general health, your disability and how it affects your ability to work. VR will ask your help in gathering copies of any existing medical reports and copies of records from: • Social Security Administration • New Hampshire Department of Health and Human Services • Department of Education officials 22 Meeting your VR Counselor/Team Once the necessary information is collected, a qualified VR counselor who is trained in rehabilitation counseling, will contact you for an appointment. He/she or a group of counselors will work with you throughout the VR process. You should complete, sign, and date an application form provided by VR at your first meeting. Once VR has your signed application, they will determine if you are eligible for services within 60 days. Be prepared to explain how your disability affects your ability to work and to describe the help you need. If you have difficulty getting to your local VR office because of your disability, be sure to discuss your needs with a VR counselor or the Client Assistance Program. 23 Status 02: Applicant When VR receives your signed application, you become a Status 02 applicant. You will receive your application at your initial personal interview with your VR counselor who will: • Explain VR services and the importance of informed choice • Offer guidance to help you exercise informed choice throughout the VR process • Ask about your disability, work history, education and financial status • Inform you of your rights and responsibilities • Answer questions you may have Your VR counselor will now begin to collect your existing medical and educational records and reports. Duration of application process VR must tell you within 60 days of the date you signed your application whether you are eligible for services. VR should notify you in writing of the eligibility decision. 24 If VR has not notified you within 60 days whether you are eligible for services, they must ask for your written agreement for more time to make this determination. VR may provide services during this 60-day period based on an interim eligibility determination. If an interim eligibility determination is made, the final eligibility decision must be made within 60-days. If more than 60 days have passed and you have not learned whether you are eligible, contact your VR counselor and the Client Assistance Program. Assessments For the most part, your VR counselor will use existing information to determine if you are eligible for services, including: • Information provided by you and your family • Counselor observations • Education records • Information and determinations made by other agencies Another way to find out about you is to evaluate you. These evaluations are called "diagnostics” or "assessments.” You should participate in decisions made regarding assessment services. 25 To evaluate you, information from other people who know you such as employers and doctors may be needed. If this kind of information is needed, you will be asked to sign a release of information form. The assessment process to determine eligibility should be completed within the 60 days of when you signed your VR application. If additional assessment services are needed to determine your eligibility and priority for services, you will not be asked to pay for them. For example, you may need an assistive technology (AT) assessment to see if any type of equipment or device (communication aid, wheelchair, etc.) could help you overcome barriers to employment. All the information and assistance you need to make decisions about the assessment process and your employment outcome should be provided. Once you are found eligible, your VR counselor may need more information. Some specific evaluations may be suggested. These assessments may include: • Medical examinations such as needed general physical or specialist exams and vision or hearing tests 26 • Psychological evaluations • Vocational assessments of interests and work skills • Provision of trial work experiences Status 06: Extended Evaluation Sometimes a VR counselor cannot decide whether you will benefit from VR services in terms of employment. Rather than find you ineligible, the counselor may place you in "extended evaluation." During this time, you are eligible for all VR services available to someone who has already been found eligible. Anyone in extended evaluation status should have an Individualized Plan for Employment (IPE). During an extended evaluation, your IPE should be renewed every 90 days. Status 08: Closure from previous statuses If VR closes your file from Status 00 (someone referred), 02 (applicant) or 06 (extended evaluation), to Status 08, you have been found ineligible for VR services. If your file is being closed as Status 08, VR should fully discuss this decision with you. VR must: 27 • Send you a written notice, or other appropriate communication that you can understand, of the decision to close your case. • Provide the reason for the closure and notice of your right to appeal the decision and a description of services available from the Client Assistance Program and how to contact CAP. If you were determined ineligible for services from VR based on a finding that you are incapable of achieving an employment outcome, VR should refer you to other programs that are part of the One-Stop service delivery system and to local extended employment providers. If you request a review by VR of their determination that you are ineligible for services because you are incapable of achieving an employment outcome, they must review their decision within 12 months and then annually. 28 Status 10: Certified Eligible for Services When your case moves into Status 10, it means that you are eligible for VR services and it is time to develop your Individualized Plan for Employment (IPE). You should receive written notification of any eligibility decision. You should be provided with information to assist you in understanding that decision and exercising informed choice. VR should have written policies and procedures that support your informed choice throughout the VR process. Except for assessment services, and interim eligibility services, most VR services are provided after your IPE is completed. Not everyone requires the same services. Services are designed to meet your unique needs. 29 Services VR has written policies and procedures covering all VR services. You should be able to choose services from any qualified provider. VR should respond to your questions and calls in a timely manner and help you exercise your informed choice. VR can provide one or more of the following services: • Vocational guidance, counseling, and referral including information about services from other agencies, the Statewide One-Stop System and the Client Assistance Program. • Information and assistance in the exercise of informed choice and where to get support services for those who need help to exercise informed choice • Education regarding possible service providers, types of services offered, and information on vouchers and the Ticket to Work Program • Assessments by qualified personnel to determine eligibility and Vocational needs, including rehabilitation technology assessments 30 • Job search, placement and retention services, personal assistance services, follow-up and follow-along services and specific post-employment services to help you in maintaining, regaining or advancing in employment • Vocational and other training services, including personal and vocational adjustment training, apprenticeship programs, post-secondary education, books, training materials and services to family members of such individuals if necessary for rehabilitation • Physical and mental restoration services, including, but not limited to, corrective surgery or therapeutic treatments, hospitalization, prosthetic and orthotic devices, eyeglasses and visual services, diagnosis and treatment of mental and emotional disorders • Maintenance for additional costs incurred while participating in rehabilitation • Interpreter services and note-taking services for individuals who are deaf • Reader services, rehabilitation teaching and orientation and mobility services for individuals who are blind • Occupational licenses needed to start or operate a small business; tools, equipment, initial stocks and supplies • Transportation in connection with the provision of any VR services • Vehicle purchase or modification to support an objective or goal of the IPE subject to financial need • Home modification services subject to financial need 31 • Telecommunications, sensory and other technological aids and devices. • Rehabilitation technology services • Transition services that promote the accomplishment of long-term rehabilitation goals and intermediate rehabilitation objectives • On-the-job or other related personal assistance service provided while receiving other services from VR • Supported employment • Technical assistance, consultation and management services for self-employment and telecommuting goals or establishing a small business operation, including occupational licenses, tools, equipment, initial stocks and supplies • Other goods and services that VR can reasonably expect may benefit an individual with a disability in terms of employability, including modification of a home and purchase and/or conversion of vehicles. • Post-employment services 32 Limitations on Services There are limitations to some of the services listed above: • Personal assistance services are provided to help individuals to perform daily living activities on or off the job site. They are provided only if other VR services are being provided • Transportation is a supportive service that contributes to the individual’s ability to participate in or receive the benefits of other VR services. Example: VR might pay for transportation costs to and from a training site. • Services to family members are provided only under certain conditions. If you want more details about this, contact your VR counselor or CAP. You and your counselor must agree about the specific services that you are to receive in order for you to meet your vocational goals. • Maintenance for additional cost incurred while participating in rehabilitation is limited. You and your counselor should discuss this if it applies to you. For example, a student who is receiving maintenance services such as room and board may be eligible to receive such services only while he/she is in school. 33 The Individualized Plan for Employment (IPE) The IPE is the most important document in obtaining VR services. You develop your IPE after you are found eligible for VR services. Your Counselor should give you all the information about options for developing your IPE in writing and in your own language. Your IPE lists the specific services you need to reach your vocational goal and shows who will provide or pay for each service. Only those services included in your IPE may be provided. You or someone you choose may develop all or part of your IPE with or without the assistance of VR. Your IPE must be a written document prepared on forms provided by VR. You should be given all the information and support services you need to help you to exercise your informed choice. 34 You should participate fully in making decisions regarding: • The options for developing your IPE • How much technical assistance you need to exercise the various options • The extent to which family members and others are to be involved in the IPE planning process • The selection of employment outcome • VR services and other possible service providers • Service and employment settings • Methods for procuring services. You are entitled to help in developing your IPE. Some options for developing your IPE include help from: • A qualified VR Counselor employed by the State of New Hampshire • A qualified VR Counselor not employed by the State of New Hampshire • Other people, agencies and services that will help you reach your job goal. Additional information to help you develop your IPE should be provided including: • Information about what must be included in an IPE • Information explaining what financial obligations you may have, if any, under your IPE 35 • Information on help you can get with completing State forms required as part of your IPE • Any other information that you request or is necessary for you to develop your IPE. • Information about your rights, the appeals process and the Client Assistance Program (CAP) and how to contact CAP. • Information about due process hearings and mediation. Development of the IPE should begin as soon as possible once you are found eligible Assistive technology and personal assistance services should be included in your IPE. It is very important that you understand the IPE completely before you sign it. You may agree with some but not all of your IPE. You can request that the parts of the plan you agree with begin. You can use the appeal process to resolve the parts of the plan about which you and your counselor disagree. 36 Use the space provided on the form to write your comments explaining the parts you agree and disagree with. Once you and your counselor have signed your IPE, it becomes your responsibility to see that you reach your employment goal. VR is there to help you reach your goal. You may ask for CAP assistance at any time in the process. It is important to save your copy of your IPE for quick reference. Your IPE should be approved and signed by a qualified VR counselor employed in the State. Your IPE is flexible and can be amended any time, if your needs, goals or timetable changes. Both you and your counselor must sign an IPE amendment. You and a qualified VR counselor must review each IPE at least every 12 months Note: If you are concerned about delays in developing your IPE, contact your counselor or CAP. 37 Status 12: IPE Completed Your completed IPE will include: • Your specific employment outcome • Services needed to reach your employment goal • A description of who will provide your services • The qualifications of service providers and when available, consumer satisfaction information • The employment setting chosen • The settings chosen in which services will be provided • Costs of services, including who will pay these costs • Beginning and end dates of services • The date you expect to reach your vocational goal • Ways that your progress will be measured as you work toward your goal • Responsibilities you will assume in achieving your employment goal • VR’s responsibilities and the responsibilities of other entities as appropriate • Supported employment requirements, if appropriate • Post-employment services, if appropriate 38 Once you are eligible, you will have a signed copy of your IPE and receive services. You must receive written notice before VR services are ended. If you disagree and do not want services ended, you have the right to ask that services continue while you use the appeal process to register your disagreement. You may contact the Client Assistance Program to help you at any time in this process. Status 14: Counseling and Guidance Only If the primary service you need is counseling and guidance, your case will be placed in Status 14. Your counselor can provide information and support to help you: • Exercise informed choice • Adjust to your disability • Understand your options • Resolve problems that prevent you from working • Gather information about the job market and your work skills Status 16: Physical or Mental Restoration: Some people need medical services to reduce the effects of a disability. These services could include: 39 • Corrective surgery or therapeutic treatment • Medications • Prosthetic and orthotic devices • Eyeglasses and visual services including visual training or other special visual aids prescribed by qualified personnel • Psychiatric or psychological counseling • Dentistry • Nursing services • Other medical or medically related rehabilitation services Whenever you need physical or mental restoration services, your counselor may ask you to explore other or comparable benefits. For example, if you have private medical insurance, Medicare or Medicaid, you will be asked to seek coverage from those sources before VR will pay for physical or mental restoration. However, if you are "at extreme medical risk" (see Definitions of Terms on page 80) or may lose an immediate job placement, VR should not delay providing services because there may be other or comparable benefits. 40 Status 18: Training Many people require training to enter or re-enter the job market. Training can include: • Vocational or technical school • College or university studies including graduate school • On-the-job-training, including apprenticeships Graduate training could be provided in certain circumstances approved by the VR Director. In cases of post secondary education, VR will ask you to apply for any grants or financial awards through your school's financial aid office. VR cannot require that you take out a loan to pay for your education or related living expense while you are in school, but they will encourage you to do so. Status 20: Services Completed If you have received all the services identified in your IPE but you are not yet working, your case should be placed in Status 20. Status 22: Employed When you go to work, your case should be placed in Status 22. You should continue to contact your counselor if you need any additional services or if the job is not working out. 41 Status 24: Services Interrupted If something beyond your control happens to interrupt your plan and interferes with your ability to continue your plan temporarily, your case may be placed in Services Interrupted status. Your case is not closed. However, VR will suspend services until your IPE is amended, moving you out of this status. Status 26: Successful Rehabilitation When you have worked successfully in suitable employment for at least 90 days and you and your counselor agree that the outcome is satisfactory, your case may be closed as successfully rehabilitated. VR should let you know in writing when your case is being closed. You should have the opportunity to be involved in the decision to close your case. Even when your VR file is closed, you should contact VR if you need a service to keep your job or if your job ends. You should be told about post-employment services that are available to help you keep or regain your current job when necessary. 42 Case closure Some case closures are not the result of successful rehabilitation. For example: • VR might propose to close a case because an individual's physical or mental condition improves to the extent that there is no longer a medical condition that is a barrier to employment. • A case might be closed if VR cannot locate you. Your case may be closed at any point in the VR process. If VR plans to close your file at any time for any reason, you should receive a written notice telling you about the closure before it happens. You have the right to appeal a closure decision. Any time VR decides to close your case, they should give you information about impartial due process hearings, the right to voluntary mediation and the Client Assistance Program. You have the right to appeal a closure decision. Contact the Client Assistance Program if you have any questions or would like more information. 43 Status 28: Closure After Services Begin If VR closes your file after you have received at least one service, it will be closed in Status 28. You should receive a letter about the closure. VR should advise you about your right to appeal and about the Client Assistance Program. Status 30: Closure Before Services Begin If VR closes your file before you have received at least one service planned in the IPE, your file will be closed in Status 30. You have the right to appeal this closure decision. Status 32: Post-Employment Services After VR ends services to you because you are "successfully rehabilitated”, other short-term services to help you maintain, regain or advance in your current job may be needed. Some examples of post-employment services are: • Your job is at risk because of conflicts with supervisors or co-workers and you need mental health services and counseling to maintain your employment 44 • Your job is eliminated through reorganization and new placement services are needed • Your employment is no longer consistent with your strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice • You may decide to purchase a vehicle and need VR's help paying for the modifications necessary for you to drive the vehicle. Services must be related to your original disabling condition. Duration of services should be based on your individual needs. Post-employment services cannot be used for acute conditions or be used merely to increase your income. You may be asked to contribute to the cost of the postemployment service if you are working and earning income. 45 Rehabilitation Technology The term rehabilitation technology includes rehabilitation engineering, assistive technology devices and services that help you overcome your disability in education, rehabilitation, employment, transportation and independent living. A device can be a piece of equipment that improves or helps your ability to function. A service can include an evaluation for a device or training to use it. Examples range from very simple items purchased at a store to those involving specialists and prescriptions. Please see the Terms section of this guide for a definition of Assistive Technology Devices and Services. 46 VR Sources of Qualified Personnel The following qualified agencies and businesses consult with VR to evaluate and recommend rehabilitation technology solutions for applicants and customers: • University of New Hampshire, Departments of Engineering and Physical Education • Crotched Mountain Rehabilitation Center, Driver Evaluation Program • Architects on contract with VR • Granite State Independent Living (GSIL) • VR Bureau of Blind Services, Technology Specialist • New Hampshire Adaptive Technology and Equipment Center (NHATEC) Who Shall Pay? Rehabilitation Technology Services are exempt from the comparable benefits provision in the Rehabilitation Act. This means that the law does not require VR to search for other available funding sources before paying for rehabilitation. VR acknowledges this provision in the law, but has made a statewide decision to use comparable benefits whenever possible to fund rehabilitation technology devices. 47 Examples of comparable benefits are Medicaid, Medicare, third party insurance and other available funding sources and grants. The purchase of devices is also subject to the VR financial needs policy. VR must maintain written policies explaining the way they determine financial need and specifically name the types of VR services subject to financial need tests. These policies must be applied uniformly to all VR customers. Note: If a rehabilitation technology device is required to establish your eligibility for VR, VR will not apply a financial needs test or pursue comparable benefits if doing so would delay the eligibility determination beyond 60 days. 48 Who can help? If you have questions regarding rehabilitation technology or need assistance in obtaining these services, you may want to contact: Client Assistance Program Governor’s Commission on Disability 57 Regional Drive Concord, NH 03301 (603) 271-4175 (603) 271-2773 (Voice/TTY) 1-800-852-3405 (Voice/TTY) bhagy@gov.state.nh.us or The Protection and Advocacy Program on Assistive Technology at: The Disabilities Rights Center 18 Low Avenue PO Box 3660 Concord, NH 033023660 800-834-1721 (Voice/TTY) NH RELAY: 1-800-735-2964 (603) 228-0432 Voice/TTY) e-mail: drc@totalnetnh.net 49 Transition from School to Work If you are a student in special education classes you are eligible for transition services. Your IPE can be developed and approved when you are fourteen years old or as early as possible during your transition planning. At the latest, it should be in place by the time you reach sixteen years of age. Your IPE must contain statements of needed transition services and you should be informed of transition planning services available. High school students with disabilities should begin planning for vocational transition with a statement of transition service needs. Students or parents can start the process or can ask school personnel to refer the student to VR. If transition is your first experience with VR, you may want to understand how VR differs from the school district in the areas of eligibility, financial participation and decision-making. 50 The School District VR Provides special education services Provides vocational services that are not the responsibility of the school Pays for educationally related services May require financial contribution from the family or customer for certain services Calls the written plan an Individualized Educational Plan (IEP) or an Individualized Transition Plan (ITP) Uses a document called an Individualized Plan for Employment (IPE) Parents usually make decisions for their school-age children Unless a person under age 18 has a legal guardian, the individual will sign forms and make decisions Must provide special education services until graduation or until student reaches 21 Services can be initiated at any age, but VR transition services should be in place by age 16 In some school districts, VR counselors are located within the school. In others, VR has developed relationships with Local Education Agencies. In either case, a vocational rehabilitation counselor is a member of the transition team, along with school personnel and other individuals who are invited to help the student in making the best decisions for his/her future. If you have any questions or concerns about transition from school to work, contact the Client Assistance Program. Supported Employment The Supported Employment process begins when VR identifies you as an applicant who could work in supported employment. You and your VR counselor will develop your IPE, which describes the Supported Employment services to be provided. VR will arrange an on-the-job evaluation lasting up to four weeks. The evaluation helps everyone involved decide whether a particular job is appropriate and helps identify your training needs. The goal of supported employment is to find jobs for people with severe disabilities who have: • Not worked in the competitive job market, or • Had sporadic or interrupted employment, or • Chronic mental illness and need ongoing supports to maintain a job Extended Supports VR will pay for services needed for initial job assessment, job development, placement and training. Typically, Area Agencies or Mental Health Centers provide "ongoing" or "extended" supports. Extended supports are services an individual needs indefinitely to maintain a job. Training and support services may be provided on-thejob or, for persons with chronic mental illness, off-thejob. An example, of off-the-job support might be mental health counseling or a "job club” where people meet after work. An on-the-job support could be a job coach. VR typically provides only three months of training and support after an individual completes the assessment stage and is working. After three months, VR should assess the need for continued training. VR may continue funding longer than three months if necessary for the individual. The VR counselor can request that VR-funded training and support services continue for up to 18 months or more if special circumstances require it for job stability. The Supported Employment program in New Hampshire is a cooperative effort. VR has joint agreements with: • The Division of Mental Health and Developmental Services • Area Agencies (serving adults with a developmental disability) • Community Mental Health Centers • High Schools 53 These agreements outline the agency that will provide resources needed to find appropriate jobs and help people keep those jobs. The jobs are located in "integrated" settings. Integrated means that most co-workers are not people with disabilities. Note: If VR has closed your case and you need a specific service to keep your job and that service is not available through your extended services provider, you may request "post employment services" from VR. Should you or someone you know be unable to participate in the Supported Employment program you may contact the Client Assistance Program. 54 Independent Living Programs Not every individual with a disability is able to work. Independent Living (IL) programs provide services to all individuals with disabilities who may need assistance with their daily living at home and/or in the community. The purpose of the IL program is to maximize the independence, productivity, leadership, and empowerment of individuals with disabilities. Eligibility You may be eligible for services from the state IL program if you have a significant disability that impedes independence. Some services available are dependent on financial need. In New Hampshire Granite State Independent Living (GSIL) provides the following four core services: • Advocacy • Peer Support Counseling • Information & Referral • Independent Living Skills Training In addition, GSIL provides the following services to those who are eligible: • Home Modification • Accessible Transportation • Adaptive Aids and Equipment (i.e., orthotics, prosthetics, environmental controls) • Interpreters for Individuals who are Deaf • Service Coordination For information on any of these programs, contact: GSIL PO Box 7268 21 Chenell Drive Concord, NH 033017268 228-9680 (Voice/TTY) 800-826-3700 (V/TTY) www.gsil.org GSIL has two satellite offices to better serve the disability community throughout the State: 4461 Main Street PO Box 871 Franconia, NH 035800871 823-5772 (V/TTY) 800-588-5772 (V/TTY) 100 Emerald St Suite B Keene NH 03431 355-1208 (V/TTY) or 877-680-4826 (V/TTY) 56 Independent Living Services for Older Individuals Who are Blind A statewide program of site based services for people who are elderly and blind (55 years of age and older and legally blind). Services include: • Peer Counseling • Rehabilitation Teaching • Low Vision Services • Orientation and Mobility For additional information on these services you may contact: Bureau of Blind Services 78 Regional Drive Building 2 Concord, NH 03301 271-3537(V/TTY) 800-299-1647(V/TTY) http://www.ed.state.nh.us/vr 57 The Statewide Independent Living Council (SILC) The Statewide Independent Living Council (SILC) develops and co-signs, along with the Director of VR, the State Plan for Independent Living, which identifies and sets priorities for services and activities in New Hampshire. For more information about the SILC, you may contact the Governor's Commission on Disability at: Governor's Commission on Disability 57 Regional Drive Concord NH 03301 271-2773 (V/TTY) 800-852-3405 (V/TTY) www.state.nh.us/disability 58 Tips for Success If problems, concerns or questions arise, talk with your counselor, your counselor’s supervisor, or other member of your counseling team. If you have additional questions or concerns, you may contact CAP at any time. The follow suggestions may help you as you go through each stage of the VR process. Be informed This guide is designed to help you - use it! You have the right to ask as many questions as you need. Talk with your counselor to be certain that you both understand and agree on the contents of your IPE. If your goals or needs change, tell your counselor you want to amend your plan. Make sure that you know: • Your vocational goal • The specific services needed to reach your goal • The time frame needed to complete objectives • Who will provide or pay for each service Note any difference of opinion you have with your counselor in the space provided on your IPE. Be aware that you have a right to appeal any decision; ask for a copy of the appeal process rules. Be organized Keep copies of all correspondence, notes, records, and documents stored together in a notebook or folder. This will be a handy reference if you have a question for your counselor or CAP about any services or decisions made.. Be specific Be specific about identifying your concerns and explaining what you want or need. Ask your counselor's opinions and advice about how to solve any concerns and offer ideas for solutions. Give your counselor a reasonable amount of time in which to respond. When your IPE is amended to reflect any change, ask for a copy of the amendment. Be responsible All services paid for by VR must be pre-approved by your counselor. Do not expect to be reimbursed for any purchases or expenditures that were not approved in your IPE. 60 If you have difficulty getting in touch with your counselor VR counselors provide services to many people at the same time. That means that counselors often are involved in meetings, on the telephone, attending appointments or doing paperwork. Some VR offices are using a team approach to make sure you will not experience delays if one counselor is busy. If you call and leave a message for your counselor but have not heard from him/her in a reasonable time, you could take one of the following actions: • Ask the receptionist at VR to connect you with another counselor on your team • Ask when would be the best time to call or list a few times when it would be best for your counselor to call you back and leave the reason why you called • Ask for the names of the VR office Team Leaders and ask to speak with one of them if you have trouble reaching your counselor or if you need attention immediately. • If it is an emergency, let the receptionist or counselor know. (800) 299-1647 Voice/TTY) • Send a letter explaining what you need and why you called to talk with your counselor. • Call VR’s toll-free telephone number at its central office in Concord 1-800-299-1647 (Voice/TTY). 61 Delays of all sorts There may be times when you need a service immediately, or you may not have received a service agreed to in your IPE. No one should have to wait for a necessary service. At these times, if nothing you have tried is working, contact the Client Assistance Program. State Rehabilitation Council (SRC) VR has a State Rehabilitation Council (SRC). The purpose of the SRC is to involve customers, providers and other interested persons in an advisory and consultative capacity to the agency. If you would like to express any views or present ideas about customer needs to VR or would like to attend a SRC meeting, call VR at 1-800-299-1647 (Voice/TTY). 62 A Few Words About Money Financial contribution Although there is no financial eligibility test to qualify for VR services, you may be required to contribute to the cost of certain services once you have been found eligible. VR may ask you to provide information about your income, expenses, assets, and debts. VR must provide the following services at no cost to you: • Evaluation of rehabilitation potential • Counseling, guidance and referral services • Placement • On-the-job training and transitional employment training • Interpreter services for individuals who are deaf or hard of hearing • Reader and mobility services for individuals who are blind • Personal and work adjustment training Depending on your financial status, you may be asked to contribute toward the cost of certain services (other than diagnostic evaluations) during extended evaluation. Any information you provide about your financial circumstances is confidential. Federal law requires that VR search out "comparable benefits" or other resources such as agencies or groups that can pay for services before using VR funds. An example of a comparable benefit is medical insurance. If the search for comparable benefits would delay services to anyone at extreme medical risk or would jeopardize an immediate job placement, this rule does not apply. Benefits planning You may be worried about losing all or part of your disability benefits when you go to work. It is a good idea to plan for work by finding out the effect earned income will have on your medical and financial benefits. Many "work incentive" programs now protect people with disabilities from total loss of Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), Medicare and Medicaid. Your VR counselor may be able to help you plan ways to keep your benefits. You may also contact Granite State Independent Living, the Governor’s Commission on Disability or the Dollars and Sense Program for more information on benefits planning. 64 You should ask about: • Medicaid for Employed Adults with Disabilities (MEAD) A Medicaid coverage group that allows adults with disabilities to work to their fullest potential, save money, and still qualify for Medicaid. The program makes a person with a significant disability who is employed eligible for Medicaid. This means is that you can work, save money, and have the option to keep or get Medicaid coverage. • The Plan to Achieve Self Support (PASS). You are eligible for a PASS plan if you receive SSDI benefits and want to become eligible for SSI. You are eligible for a PASS plan if you want to maintain SSI eligibility when you work. The Plan to Achieve Self Support (PASS) is a method used to establish or maintain eligibility for Supplemental Security Income (SSI). It is a way to set aside funds for future or current uses that will help achieve a specific vocational goal. If you receive Social Security Disability benefits and are not now eligible for SSI, you may still be able to write a P.A.S.S. You can write your plan in consultation with whomever you want. Your plan must be approved by the Social Security Administration. A PASS plan initially lasts for 18 months. The PASS plan can be renewed for another eighteen months and again for twelve more. • Extended Period of Eligibility (EPE) if you receive SSDI benefits with or without Medicaid 65 • Impairment Related Work Expenses (IRWE) if you receive SSDI or SSI disability • Nine Month Trial Work Period if you receive SSDI benefits • Subsidies if you receive SSDI benefits, especially if you are involved in Supported Employment • Continued payment to individuals under a vocational rehabilitation plan (Section 301) if you receive SSDI or SSI disability benefits 66 Your Rights as a Vocational Rehabilitation Customer VR makes certain guarantees to you as an applicant or customer, including the right to: • Confidentiality • Informed choice regarding available services • Courteous, respectful treatment • Services provided without regard to race, language, religion, sex, sexual orientation, age, national origin or disability • Review your VR file • Receive advance, written notice before VR ends a service identified in your IPE before its scheduled completion date • Ask that a service continue while the proposal that it end is reviewed • Obtain written decisions from VR with an explanation and a notice of appeal rights • Appeal any decision made by staff of VR • Making decisions regarding development of your Individualized Plan for Employment (IPE) • Make decisions for yourself if you are age 18 or older and do not have a legal guardian • Expect that VR programs and services are accessible and barrier-free, including documents and correspondence in your preferred choice of format: Braille, large print, computer diskette, etc. 67 Your Right to Appeal As an applicant for or customer of VR services you have the right to appeal if you disagree with any decision made by anyone in the system about providing or denying services. If you request an appeal, VR is required to provide you with information about the following: • Free assistance from the Client Assistance Program • The voluntary mediation process • The Fair Hearing process If you need an interpreter, or a reader, or require transportation, VR must pay for these services. It is best to notify VR of any need for an accommodation when you request an appeal. You have the right to review your case file. When you have a representative or attorney working for you, he or she can review your file on your behalf by presenting an authorization for release of information, signed by you. You have the right to choose which appeal option you would like to pursue. The staff of CAP is available to discuss these options with you. CAP can answer your questions about the appeals process and advise you how to proceed. NOTE: VR will attempt to resolve conflicts informally or through mediation with a third party who is not directly involved with the issue. If you choose this option, you have the right to representation during the appeal process. The Appeals Process You can request an appeal either in writing or orally if it is impractical to submit a written appeal. Direct your request to your VR counselor. You should also notify the VR Central Administrative Office in Concord about your request. The best way to ensure that VR promptly deals with your request is to: • Make a written request • Send the request to your VR counselor, and • Send a copy of the request to Director Central Administrative Office Division of Career Technology & Adult Learning Vocational Rehabilitation Program 78 Regional Drive Building 2 Concord NH 03301 69 Fair Hearings A fair hearing is a more formal appeals process, conducted by an Impartial Hearing Officer. The hearing officer who will hear your case is selected: • From a pool of qualified persons • On a random basis • By agreement between you and the Director of VR • If applicable, by agreement between your parent, guardian, advocate or authorized representative and the Director In New Hampshire, the hearing officers are lawyers who contract with the State Department of Education. Hearing Procedures CAP is available to discuss these procedures with you and to help you with the possibility of finding legal representation. During the hearing, you or your representative will have the opportunity to present your case, introduce evidence, and argue all issues involved. The proceedings are tape-recorded. You should receive notification of the hearing decision within 30 working days after the date of the 70 VR Director review The Director of VR may review the decision of a hearing officer. If the Director decides to review, you will have the opportunity to submit additional evidence and information that you feel may affect the final decision. The Director shall notify you of the intent to review within 10 Days of the mailing of the hearing officer's decision. The Director may NOT overturn or modify a decision unless the Director concludes, based on clear and convincing evidence, that the hearing officer's decision is contrary to Federal or State law, including policy. Appeal of VR Director's decision You may want to appeal the decision made by the Director, following his review of the Hearing Officer's decision. If so, your appeal must be filed with the New Hampshire Supreme Court. 71 How The Client Assistance Program Can Help Every state that receives federal funds for a Vocational Rehabilitation program must have a CAP. In New Hampshire, the Governor's Commission on Disability administers the New Hampshire Client Assistance Program. It is CAP’s job to give applicants and customers of VR information and advice about their rights under the Rehabilitation Act (the Act) of 1973, as amended and Title I of the ADA. When it is appropriate to do so, the CAP may advocate for in their relationships with projects, programs and facilities to ensure the protection of their rights under the Act. In New Hampshire, programs funded under the Act include: • NH Department of Education • Bureau of Vocational Rehabilitation including the Bureau of Blind Services • Granite State Independent Living 72 The Client Assistance Program can • Provide Information and referral on disability-related issues to the public • Advise people of all benefits available under the Act and related Federal and State assistance programs • Assist VR customers and applicants with help necessary to ensure the protection of their rights under the Act • Advise State and other agencies of ways to improve VR performance The Americans with Disabilities Act (ADA) The CAP can provide information on the available services and benefits under Title I (Employment) of the ADA, with special regard for individuals unserved or underserved by vocational rehabilitation programs. Mediation Before pursuing administrative and legal remedies for an individual, CAP relies on mediation to the maximum extent possible. Limitations on Client Assistance Program activities CAP cannot help people pursue class action lawsuits. 73 When VR must advise you Of the Client Assistance Program VR must tell you about CAP at these times: • When you submit your application for VR services or other programs under the Act • When you receive a notice of ineligibility • On your Individual Plan for Employment (IPE) • When your case is to be closed. How to contact the Client Assistance Program The CAP's office is located at the Governor's Commission on Disability. Office hours are 8:00am 4:30pm, Monday - Friday. You can contact the CAP by mail, telephone, e-mail or in person at: Client Assistance Program Governor’s Commission on Disability 57 Regional Drive Concord, NH 033018518 1-800-852-3405 toll free (Voice/TTY) 603-271-2773 (Voice/TTY) FAX: 603-271-2837 e-mail: bhagy@gov.state.nh.us 74 When to contact the Client Assistance Program CAP services are available to anyone seeking or receiving services under the Rehabilitation Act or Title I of the ADA. Contact CAP with any disability related questions. Contact CAP for Information and Referral services. Contact CAP to advise, assist, advocate, mediate, negotiate, and represent clients of VR and Independent Living. CAP services are free and confidential. 75 DEFINITIONS OF TERMS ADVOCATE — an individual who pleads the cause of another. APPROPRIATE MODE OF COMMUNICATION — Special adaptive aid and support to help you understand and respond to information. Some examples are interpreters, open and closed captioned videos, specialized telecommunications services and audio recordings, Braille and large print materials, electronic format materials, augmentative communication devices, graphic presentations and simple language. AREA AGENCY — a nonprofit corporation that provides services to individuals with developmental disabilities in New Hampshire. There are 12 Area Agencies in the state, each providing services in a particular geographic area or region. 76 ASSESSMENTS — existing information and additional reports used by VR to decide if a person is eligible for VR services. Assessments are also used to help identify what services are needed. Assessments may include personality, interests, functional capacities, vocational aptitudes, intelligence level, educational achievement, work experience, interpersonal skills, employment opportunities and other data. Applicants or customers will not be asked to pay for the cost of assessments necessary to determine eligibility or continued eligibility for VR. ASSISTIVE TECHNOLOGY (AT) DEVICE — any item, piece of equipment, product or service which is specially made to assist people with disabilities in carrying out daily activities. AT devices may increase, improve or maintain capabilities. AT devices can be acquired commercially, modified, or customized. ASSISTIVE TECHNOLOGY SERVICE — any service that directly helps an individual with a disability choose, get or use an Assistive Technology service. These include: • Evaluation of needs • Providing for the acquisition of AT devices • Selecting, adapting, repairing or replacing AT devices • Training or technical assistance for an individual, or, where appropriate, his or her family 77 • Training or technical assistance for those who provide services to employ individuals with disabilities or are otherwise substantially involved in the major life functions of individuals with disabilities CLEAR AND CONVINCING EVIDENCE — Evidence that cannot be disputed using the highest standard in our civil system of law and applied individually; i.e., wellfounded evidence. CLIENT ASSISTANCE PROGRAM (CAP) — an advocacy program ad