1125.00 Consumer Participation in the Cost of Services Policy

(January 1991)
(Amended April 2007)

 

Table of Contents

Legal Basis

  1. Rehabilitation Act of 1973 as amended
  2. Code of Federal Regulations Chapter 34, Part 361.47
  3. Regulations of the Commissioner of Education, Section 247.11

Purpose and Scope

The Federal regulations governing the vocational rehabilitation program give state agencies the option to consider the financial need of persons with disabilities when determining who should pay for the cost of rehabilitation services. VESID has chosen to measure the financial need of individuals to determine the extent of their participation in the cost of their services. In this way, VESID's resources can be targeted to consumers most in need. In addition, consumers' participation in the cost will strengthen their commitment to the success of their rehabilitation program.

Policy 1125.00

Services not based on economic need

The following services are provided by VESID without considering a person's financial resources. (Note: this does not eliminate the requirement, where appropriate, to first use all available comparable benefits the person is eligible to receive before using VESID funds):

  1. all diagnostic and evaluation services, including maintenance and transportation during evaluation;
  2. training at, and transportation provided by approved rehabilitation facilities;
  3. special transportation required by individuals with severe disabilities;
  4. books and related training materials;
  5. reader and note-taking services;
  6. tutoring;
  7. attendant services;
  8. interpreter services;
  9. vocational counseling, guidance and referral;
  10. job coaching services and other supported employment services;
  11. on-the-job training;
  12. work-study training;
  13. cost-effective training at a BOCES, business or trade school or community college up to $4,815 as described on p. 5 of this policy;
  14. job placement.

Services based on economic need

The following services may not be provided until available consumer resources have been applied toward the cost:

  1. all training services, including tuition and related fees at colleges and universities, with the exception of training at approved rehabilitation facilities, work-study, on-the-job training and cost-effective skills training;
  2. physical and mental restoration services;
  3. maintenance (except during evaluation);
  4. medical care for acute conditions arising during the program;
  5. transportation (except during evaluation, special transportation and transportation to attend an administrative review or fair hearing);
  6. occupational tools and equipment;
  7. stocks and supplies for self-employment;
  8. occupational and business licenses;
  9. modifications to homes, vehicles and worksites;
  10. telecommunications, sensory and other technological aids and devices;
  11. driver training (except at approved rehabilitation facilities and regionally accredited adaptive driver training centers or other driver training providers if the cost to VESID does not exceed the cost at the regionally accredited adaptive driver training center closest to the consumer.);
  12. services to other family members;
  13. all other goods and services not exempt in III. A above.

Persons Exempt from Consideration of Available Resources

The following consumers are provided services by VESID without considering their available resources if verification of receipt of benefits has been received by VESID:

  1. public assistance recipients
  2. supplemental security income recipients; and
  3. Social Security Disability Insurance beneficiaries.

Special circumstances

Room and board in lieu of special transportation

Under VESID's general economic need policy, maintenance, including room and board, is subject to consideration of available resources. However, special transportation services are excluded from such consideration for consumers who require special transportation because their disabilities are so severe as to preclude the use of public or personal transportation. For some trainees, residing on campus or at the training site, may be advantageous when compared with commuting by special transportation carriers. In such cases, consideration of available resources may be waived if room and board replaces the special transportation service for which the consumer would otherwise be eligible. The following circumstances must be met:

  1. The consumer is in need of special transportation based on a determination by the counselor and consumer that public and personal transportation cannot be used because of the severity of the disability; and
  2. The counselor and the consumer have determined that residing on campus or at the training site meets the consumer's living needs; and
  3. The cost of residing on campus or at the training site is equal to or less than the cost of providing special transportation

In this comparison, the costs of residing on campus must include room and board and any extra costs that VESID would incur, such as attendant services, special campus transportation, necessary room modifications or adaptive devices. These costs must be detailed in writing by the counselor and compared to the potential cost of special transportation for the same period of time. This documentation must be prepared before completion of the Individualized Plan for Employment (IPE) and must become a permanent part of the case record. The amount of room and board provided may not exceed the maximum level of funding for that service (currently $1,350 per year or $26 per week). However, VESID can pay for room and board above the maximum if the cost to VESID, including support services, is less than the total cost of commuting to school and other support services at an alternative program. This is especially useful at schools such as Gallaudet or National Technical Institute for the Deaf which provide special support services for students who are deaf.

Cost effective skills training

In order to provide training in the most cost effective manner, consideration of available resources may be waived to allow skills training at proprietary vocational schools, community colleges and BOCES that may be comparable to training at a rehabilitation facility if:

  1. The maximum allowable cost to VESID for tuition, books and fees does not exceed $4,815; and
  2. The skills program for which consideration of available resources is waived does not exceed one year in duration and must be a non-degree program. Up to two years may be allowed for BOCES programs that operate on half-day sessions or for trainees whose disabilities require part-time attendance, as long as the total cost to VESID does not exceed $4815.

In order for the waiver to be approved, all program costs, including tuition, books and fees, must be documented on the plan for service. The plan for service, which includes cost effective training, must be signed by the counselor and the senior counselor. Any costs in excess of the $4,815 waiver limit are subject to consideration of consumer resources.

Driver training

VESID does not consider available resources when a person with a disability attends driver training at a regionally accredited adaptive driver training center. VESID also does not consider available resources at other driver training providers if the cost to VESID does not exceed the cost at the regionally accredited adaptive driver training center closest to the consumer and which provides the training appropriate to the consumer's needs as identified in the IPE.

General Instructions for Determining Available Resources

Family Unit

The counselor must thoroughly investigate the economic circumstances of the family unit. The counselor must also determine whose income and assets to include in the family unit. The following persons must be included in the family unit, and their income and assets must be considered when determining available resources:

  1. the consumer;
  2. the consumer's spouse; and
  3. the consumer's parents, stepparents or legal guardians. If the consumer has not received more than one-half of his or her total support from the parents in the most recent calendar year, they are considered independent and their parents' income will not be included in the family unit. If the consumer has lived independently for one year or more and must return to live with the parents due to the onset or exacerbation of his/her disability, parental resources can be excluded as long as the consumer is not claimed as a dependent on the parents' income tax return.

Resources from siblings, non-supporting divorced parents or spouses who have abandoned and are not contributing to the home are not considered available resources.

Calculation of Consumer Participation

Instructions for completing VES-310

Available Income

Lines 1A, B, C: If available, enter adjusted gross income from most recent year's federal tax returns for all members of the family unit. If federal tax returns were not filed, complete an Income Calculation Form (VES-311) on reverse of VES-310 for each member of the family unit who did not file a federal tax return. If income has changed significantly since the previous year's tax return, complete an Income Calculation Form (VES-311) using current year income.

Line 2: Add lines 1 A, B, C.

Line 3: Locate family unit size and number of wage earners on Table 1 and enter family living requirement.

Line 4: If the family unit's actual expenditures for housing and/or transportation exceed the yearly budget allowances shown on Table 3 of the Expenditure Worksheet (VES-312), the Expenditure Worksheet must be completed according to the instructions on the Worksheet. Enter the result on line 4 of the Calculation of Consumer Participation Form VES-310.

Line 5A: Calculate annual available income by subtracting line 3 and line 4 from line 2.

Line 5B: If service being provided is a one time purchase such as hearing aid, prosthetic device, etc., multiply the annual available income by .25.

Available Assets:

Lines 6 A, B, C: For all members of the family unit, include only those assets listed, since these can be readily liquidated for purposes of participating in the rehabilitation program. Pensions, deferred compensation and IRA's are not included as assets.

Line 7: Add lines 6 A, B, C.

Line 8: Locate family unit size on Table 2 and enter asset exclusion.

Line 9: To calculate available assets, subtract line 8 from line 7.

Total available income and available assets:

Line 10: Add lines 5A or 5B, whichever is less, and line 9.

Unusual Expenses:

Lines 11 A, B, C, D: Unusual expenses are limited to:

  1. medical and dental expenses included on the family unit's federal income tax return or calculated on the Income Calculation Form VES-311, lines 23 through 26;
  2. court-ordered obligations other than alimony;
  3. postsecondary expenses of other members of the family unit, up to VESID's service maximums; and
  4. unusual, one-time expenses incurred during the period for which available resources are calculated that are not within the discretion of the consumer or his/her family, such as flood damage, necessary replacement of well; loss due to theft.
Total Unusual Expenses:

Line 12: Add lines 11 A, B, C and D.

Total Resources Available:

Line 13: Subtract total unusual expenses (line 12) from total available income and available assets (line 10). This is the amount that the consumer is expected to contribute to the cost of the vocational rehabilitation services included in his or her IPE.

Signatures:

The consumer must read the statement on the bottom of the Calculation of Consumer Participation Form VES-310 and sign it. The consumer must also sign Form VES-311 and Form VES-312.

Collection of Financial Information

  1. The determination of consumer participation is an integral part of the rehabilitation planning process between the consumer and the counselor. The counselor and consumer should determine the members of the consumer's family unit and should collect information about income, assets and other expenses. The consumer and family unit should be the primary source of information regarding resources. The counselor may ask consumers to produce evidence of the resource information (e.g., copies of tax returns, wage statements, etc.), but documentation of income, assets, unusual expenses, etc. should be included in the case folder only if there appears significant reason to verify the information provided. If the consumer claims to be independent from family resources, they should be asked to demonstrate their means of self-support.
  2. Consumer participation must be calculated at least annually at the time an IPE is prepared. Consumer participation should also be recalculated if income, assets or unusual expenses change significantly during the rehabilitation program..
  3. VESID will strictly observe the confidentiality of all financial information obtained from the consumer and family members.
  4. If the consumer refuses to provide the information necessary to determine participation, no service requiring such determination may be authorized. If the consumer cannot obtain the information from another member of the family unit or the family member refuses to accept responsibility for their expected contribution, the counselor and senior counselor should attempt to persuade the family to release the information and/or accept responsibility for their expected contribution. If the family still refuses, they should provide a signed statement justifying reasons for refusal. The family's unwillingness to cooperate must be documented in the case folder. If, in the judgment of the District Office Manager, the family has provided compelling, convincing justification for their refusal to cooperate, the counselor may determine consumer contribution based solely on the information available from the consumer. If the District Office Manager decides that the refusal is not justified, no service requiring determination of available resources may be authorized.

Reference:

  • Memo on Economic Need – One-Time Service Calculation dated 12/16/03
  • Memo on Economic Need Clarification dated 3/17/92
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