Informed Choice

Career Planning Chapter. Informed Choice is a partnership between the specialist and the individual by which exploration of options occurs at each point in the person’s planning and service implementation. Informed Choice is a flexible, ever moving process, empowering an individual to consider a range of options towards self-determination. In the end, both the individual and the specialist hold responsibility for the decisions made and for the outcome of those decisions. 

The client is an equal partner in deciding on the range of team and community supports needed to achieve the IPE Employment Outcome. VR staff are responsible for assisting persons with disabilities in making informed choices about services, service providers, procurement methods, reason for any “sole source” determinations, and with their pending financial obligations and responsibilities. Consideration should also be given to any cost of maintaining the purchase.

 

Client contribution 

Client Contribution Policy. Nebraska VR will not ask clients to contribute to the cost of services unless the cost exceeds the cost containment guidelines (Rule 72). Individuals will not be asked to participate in the cost of any service necessary for determining their eligibility for the program or assessment for determination of vocational rehabilitation needs.

 

Client Accountability

Client Accountability Policy. VR has a responsibility to ensure that state and federal funds used for case services are spent appropriately and as identified on the rehabilitation plan. VR staff are responsible for informing consumers of the policies surrounding the use of cash advances and vendor authorizations for purchases of goods and services. Clients must be held accountable for using the cash advance and/or vendor authorizations to purchase what is authorized and agreed upon in their rehabilitation plan. VR Staff are responsible for informing the clients of the consequences of misusing funds. 

 

Comparable Services and Benefits 

Comparable Services and Benefits Policy. VR staff must seek out and utilize all comparable services and benefits to meet, in whole or part, the costs of required and necessary services. Clients are required to apply for and use comparable benefits. 

Rule 72 - 003.01. Program services and funds may supplement, but not supplant, those services and benefits available to a recipient and his or her family from any outside agency or entity. If comparable services and benefits are currently available and ready for immediate use, they must be used to meet, in whole or part, the cost of program services.

Rule 72 – 003.02. If any public entity other is obligated under Federal or State law to provide or pay for any services considered to be vocational rehabilitation services, than VR funds cannot be used to provide or pay for such services.

Rule 72 - 003.03. Applicants for and recipients of services must apply for and accept any existing comparable services or benefits to meet, in whole or part, the costs of required and necessary services. Comparable services and benefits includes services and benefits that are provided or paid for, in whole or in part, by other Federal, State, or local public agencies, by health insurance, or by employee benefits. 

Rule 72 - 003.04. The requirement to determine the availability of comparable services and benefit does not apply if this would interrupt or delay –

• The provision of vocational rehabilitation services to any individual who is determined to be at extreme medical risk, based on medical evidence provided by an appropriate qualified medical professional.
• An immediate job placement; or
• The progress of the individual for more than thirty (30) days toward achieving the employment outcome identified in the individualized plan for employment.

 

Cost Estimates

Procurement - Case Services Policy. Cost estimates are required for services, goods and supports that are not subject to an established fee or specified amount in Rule 72. All cost estimate must be documented in the case service record. 

Rule 72 - 004.03. 

• One cost estimate must be obtained for $1,999.99 or less. 
• Two documented estimates must be obtained for individual items $2,000 - $4,999.99. 
• Three documented estimates must be obtained individual items $5,000. 

NOTE: Bids for assistive technology are only valid for 30 days. As a result, VR should meet with the client as soon as possible upon receiving the report to review the results

 

Least Cost Alternative

Rule 72 - 004.01. Considering all available alternatives, including those services which can be provided directly by VR staff without additional cost to the program, the program will procure the least expensive, comparable services, goods and supports which meet the recipient's needs. 

If there are several options to addressing the client’s need, the goods/services selected must be the least cost option(s).The client is responsible for paying for the excess cost incurred if they choose a higher cost item. 

 

High Cost Approval (over $2,000)

Exceptions and Approvals Policy. Goods and services not part of the Rule 72 fee schedule require Office Director approval if they exceed $2,000. VR Certificate Programs and Project Search Worksite Skills Trainer are exempt from this approval.

 

Rule 72 Fee Schedule

Rule 72 – Appendix B. The Rule 72 fee schedule for goods and services contains costs and assures the availability of program services to the largest number of individuals with significant disabilities. The intent of the schedule is to assure costs are the lowest reasonable cost, while allowing for sufficient flexibility to meet an applicant’s or recipient’s needs. 

Exceptions and Approvals Policy. Exceptions to the fee schedule may be made if there is no alternative to addressing a clients need for a service necessary to determine eligibility or achieve the employment outcome on the approved Individual Plan for Employment. No exceptions can be made to how VR will pay.

 

Loan Options (If the purchase will exceed the Rule 72 fee schedule or needed for Self-Employment Start-Up expenses)

Discuss with the client exploring a loan through one or both of the following –

• Personal Bank - A client can apply through their personal bank for loan eligibility; 
• Easterseals Alternative Financing Solutions (402) 930 - 4106 or 1(800) 471-6425 loan@ne.easterseals.com). There are three separate funds available to assist individuals with impairments in qualifying for lower interest rate loans, which is more likely to approve a loan than a traditional bank. 

Alternative Financing Program: For any assistive device or service (selection, acquisition or use of an assistive technology device) requiring a loan between $2,000 - $35,000. 

Telework: For any assistive device or service necessary to secure a telework opportunity from home or overcome a barrier to employment requiring a loan between $1,000 - $35,000.

Credit Building Mini-Loan: For any assistive technology device or service requiring a loan between $100 - $1,999. Can include financial coaching and building up credit report.

The Easterseals Loan Committee meets every week resulting in timely decisions on loan applications. Ensure referrals are made to Easterseals loan program as soon as possible, as bids secured from vendors are only valid for 30 days. The reports from both ATP and AgrAbility are helpful in the loan process as they explain the need for the assistive technology, as well as the cost estimates and could expediate the determination. The client can share all, part or none of the assistive technology report(s) with the loan committee. 

PURPOSE -  To provide a summary of information to consider before the purchase of goods/services are made for a client. See Chapters referenced for additional details and information.

POLICY - All goods/services purchased must be necessary for determining eligibility, assessment, or participation in the IPE.

Prior to the purchase of any goods and/or services the VR Specialist must:

• Determine if there are other reasonable options available to address the need;
• Complete a thorough search for comparable services and benefits to meet, in whole or part, the costs of required and necessary services; all clients are required to apply for and use comparable services and benefits.
• Discuss worksite items with the employer as a reasonable accommodation;
• Explore insurance and community resources for all medical items;
• Determine if the assistive device is available through the reuse program
• If the cost will exceed the cost containment guidelines (Rule 72), discuss financing available from grants, loans, personal or family resources including client contribution, and other resources, to offset a part or all of the costs for necessary goods and/or services;
• Ensure the client can afford to maintain, repair, and replace the goods, if necessary.