1345.00 Homemaker Services Policy

(February 1987)

 

Table of Contents

Description

Homemaking is recognized as gainful work and as such may be an appropriate occupational objective for any consumer, man or woman, depending upon individual needs and circumstances. In order for homemaking to be considered a gainful occupation, the following requirements must be met:

  1. Substantial homemaking work activities must be performed by the individual.
  2. There must have been benefits derived from VR services which improve the consumer's ability to function in these tasks.

Policy

  1. The basic eligibility requirements for homemakers are the same as for any other consumer.
  2. Homemakers may be provided with those VR services (subject to limits set by VESID policy and procedures) that are appropriate and necessary to enable the individual to perform substantial homemaking activities. These services may include counseling/guidance, physical restoration services, training in homemaker skills, modest home modifications and/or adaptive household equipment needed to meet the functional needs of the consumer in the performance of homemaker functions.
  3. A homemaker is a man or woman who maintains an independent household and personally performs substantial work in that respect. Homemaking is not restricted to individuals who have previously functioned as homemakers and may include individuals who live alone as well as individuals for whom a change in vocational objective to homemaking is determined to be most suitable.
     
    1. Individuals living alone may be considered as homemakers. However, there may be greater difficulty in justifying this objective than when the consumer is responsible for the homemaking activities of a family. The major problem is one of differentiating between self-care and home-maker activities. Comparison must be made to separate those activities of daily living which a person usually carries out in his(her) everyday life which are entirely different from the homemaker's household activities. The former relate to direct physical needs (self-care)* such as hygiene, dressing, mobility and eating, while the latter are concerned with maintaining a suitable living environment, such as cleaning, cooking, shopping, etc.
      *Self-care activities are not sufficient to meet the definition of a gainful occupation.
    2. The validity of closing cases of consumers as rehabilitated when the vocational objective is changed to homemaking during the rehabilitation process is dependent upon whether the particular circumstances meet the following required criteria. Substantial vocational rehabilitation services must have been provided and those services must contribute to the consumer's vocational adjustment and capability as a homemaker. In addition, the individual must actually be carrying out substantial homemaker activities.
      Family status and earnings are not conditions of closure for the homemaker, nor are other factors such as the expectation that the vocational rehabilitation of the homemaker free another family member to engage in competitive employment. While such results are desirable, they constitute secondary gains upon which closure is not contingent.
      In some situations, the consumer may not be the only individual in the household performing the homemaking activities. Under such circumstances, it must be determined that the consumer has major responsibility for and is performing the substantial homemaker activities. The counselor should seriously question the appropriateness of a homemaker goal if VESID services will not enable the consumer to perform at least 75% of all the homemaking activities necessary to operate the household adequately. Only one individual in a household can be provided with VR services to achieve the vocational objective of homemaker.
  4. The counselor should approach homemaking as a valid occupational objective in planning the consumer's rehabilitation program but the appropriateness of the objective must be justified and either an initial or amended IPE developed with the consumer.
  5. There are three classes of homemakers/home modification evaluations and/or services.
     
    1. Class I - For these evaluations, the VR counselor completes the homemakers assessment and report form and then is able to proceed to develop a plan (IPE) and implement services including counseling, no cost training and placement. Services may include the areas of family finance, household equipment, food and nutrition, consumer economics, and general household tasks. This assessment may be done jointly with the consumer or by the counselor alone using information in the case record. In some cases, however, the counselor's assessment will indicate the consumer has special evaluation needs that necessitate securing the services of an evaluator with special qualifications. These are Class II or Class III evaluation/services.
    2. Class II - These evaluations/services are carried out by a qualified homemaker evaluator and are required when the counselor's assessment indicates that special adaptive homemaker equipment and/or special homemaker training programs are needed.
    3. Class III - These evaluations/services include homemaker and/or home modification evaluations (see Manual Section 1340 for details on Home Modifications, Adaptive and Household Equipment Services).
  6. Qualifications for homemakers/home modification evaluators:
    1. Class I
      Vocational Rehabilitation Counselor or individuals with comparable experience.
    2. Class II
      1. A bachelor's degree in home economics**, and
      2. One year of experience in a rehabilitation setting including experience with homemaker evaluations.
      3. Possession of a current, valid license for the profession of occupational therapy or physical therapy and at least one year of experience in the field of rehabilitation including experience with homemaker services.
    3. Class III
       
      1. Possession of a current, valid license for the profession of occupational therapy or physical therapy and at least one year of experience in the field of rehabilitation including experience with homemaker/home modification evaluations and services.
      2. Practice in related rehabilitation profession, e.g., rehabilitation nurse, rehabilitation engineer, etc., with
         
        1. bachelor's degree, and
        2. Two years of experience in the field of rehabilitation including experience with homemaker/home modification evaluations and services. A master's degree of 30 graduate credit hours in rehabilitation may be substituted for one year of experience.
      3. Possession of a current, valid license as an architect and at least one year of experience in evaluating and modifying structures to meet accessibility standards for persons with disabilities.
        **The course of study commonly known as home economics may also be known as consumer and family studies or by some other name. Contact the Bureau of Provider Review to determine the appropriateness of the course of study if the course of study is not clearly home economics.
      4. Possession of a current, valid license as a contractor or substantiation that the contractor meets all local contractor requirements for the job tasks; also the contractor must have at least one year of experience in evaluating and modifying structures to meet accessibility standards for persons with disabilities.
        Counselors will make the determination as to which of the above qualifications apply to obtain services that are appropriate for the consumer's disability.
  7. Limitations on VESID financial participation apply to the services of home modification and household/adaptive equipment as described in Manual Section 1340.00. No IPE or combination of original IPE and amendments may exceed $7,500 for these services (combined modifications and equipment) for an individual consumer.

Instructions

The counselor should complete Form VES-755, Homemaker Functional Assessment Report, and secure any special evaluations necessary. After implementing the IPE, complete the necessary inspections to insure that sources comply with evaluation recommendations whenever home modifications and/or adaptive equipment are provided.

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