1370.00 Rehabilitation Technology Policy
(Rev. April 1994)
See corresponding procedure: 1370.00P Rehabilitation Technology Procedure
Table of Contents
- Assessing the Need for Rehabilitation Technology
- Responsibility of Others in Providing Rehabilitation Technology
- Qualification and Approval of Providers of Rehabilitation Technology
- Service Limits
Rehabilitation technology is an individualized service which can assist individuals with disabilities overcome barriers to full participation in education, rehabilitation, employment, transportation, independent living, and recreation. ACCES-VR will only support rehabilitation technology that is necessary to achieve the individual's vocational objectives and goals.
An individual's need for rehabilitation technology should be considered at any stage of the vocational rehabilitation process. When determining an individual's eligibility and vocational rehabilitation needs, rehabilitation technology will be provided if necessary to assess and develop an individual's capacity to perform in a work environment. Before an individual is determined ineligible because he or she cannot benefit from services, rehabilitation technology must be considered. Once an individual has entered extended evaluation or been determined eligible, rehabilitation technology must also be considered when planning the IPE and choosing a vocational goal. When appropriate, the IPE will include a statement of the specific rehabilitation technology services necessary to achieve the intermediate rehabilitation objectives and long-term rehabilitation goals.
Rehabilitation technology means the systematic application of technologies, engineering methodologies, or scientific principles to meet the functional needs of persons with disabilities. This includes rehabilitation engineering as well as assistive technology devices and services. Rehabilitation technology includes only those devices or services required to overcome the functional limitations imposed by an individual's disability.
Devices or services that are available under a prescription from a qualified health care professional, and/or are available through Medicaid or third party medical insurance (including prosthetic and orthotic devices, wheelchairs, hearing aids, etc.) are considered restoration services, not rehabilitation technology. Devices or services required solely for training or employment that are not the result of the person's disability are considered equipment, not rehabilitation technology.
Assistive technology device means an item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities.
Assistive technology service means any service that directly helps an individ0ual with a disability select, acquire, or use an assistive technology device, including:
- assessing the needs of an individual with a disability, including how the individual functions in his/her customary environment or the environment where the device will be used, such as the home or worksite;
- purchasing, leasing, or otherwise providing assistive technology devices;
- selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices
- coordinating and using other therapies, interventions, or services with assistive technology devices;
- training or technical assistance regarding rehabilitation technology required by an individual with a disability, or, where appropriate, other family members;
- training or technical assistance regarding rehabilitation technology needed by the individual for others who play a major role in the individual's life. This could include professionals, employers, or other individuals who provide services such as education and rehabilitation.
To the maximum extent possible, all assessments for rehabilitation technology will be conducted in the individual's customary environment or the environment where the technology will be used, such as the home or worksite. The assessment will provide:
- pertinent background information about the individual, including, as appropriate, the person's expressed needs and preferences, prognosis, and functional limitations in terms of employment outcomes that the technology must address;
- functional information about the system, environment or site that the individual uses or will use, including limitations;
- a detailed recommendation of the specifications for a device, system, or service with justification, including advantages over other options, how it addresses the individual's functional limitations and vocational goals, maintenance cost, and cost/benefits. If a brand or a model is specified, generic equivalents should also be allowed;
- at least three alternatives considered, including a comparison of features, future expansion capabilities, costs, reliability, etc. If fewer options are considered, the reasons should be documented;
- the requirements for delivering the service, including training of the individual, family members and/or employer, necessary modifications to the system or site, follow-up schedule, and potential provider(s).
Providing Rehabilitation Technology
ACCES-VR support for rehabilitation technology will be based on the following:
- The individual will be a primary participant in determining the need for and appropriateness of recommended technology. However, final decisions regarding the purchase of rehabilitation technology involving ACCES-VR's funds are the responsibility of ACCES-VR.
- ACCES-VR will only support rehabilitation technology that is necessary to determine eligibility or to achieve the individual's vocational objectives and goals because of the functional limitations of his or her disability.
- ACCES-VR will support the most cost-effective device or service that meets the vocational needs of the individual. The individual may choose to obtain more sophisticated or costly devices or services if he or she makes up the difference in cost.
- Economic need must be established for the purchase of rehabilitation technology services, other than to assess eligibility and vocational rehabilitation needs.
- ACCES-VR will not delay services to determine if comparable services and benefits are available under any other program before providing rehabilitation technology with vocational rehabilitation funds. However, medically prescribed technological aids, devices and services that are funded under Medicaid or other third party insurance are considered physical restoration services, not rehabilitation technology, and can only be purchased by ACCES-VR after comparable benefits and services are considered.
- Equipment and devices will remain the property of ACCES-VR until ACCES-VR transfers ownership once the individual is successfully employed. The individual must acknowledge in writing that he or she understands that ACCES-VR retains ownership and will return the equipment or device to ACCES-VR, or repay ACCESVR, if the goals of the IPE are not met.
- ACCES-VR will pay for the initial acquisition and installation of the system, software and supplies needed to achieve the individual's rehabilitation goal. Routine maintenance and repair is the responsibility of the party who owns the device. That is, until closing a person's case as successfully rehabilitated, ACCES-VR will pay for maintenance and repairs of the device not covered by warranty. After ownership is transferred to the individual at the time of placement and successful completion of the IPE, the individual is responsible for all future costs of maintaining and repairing the device.
- ACCES-VR will pay for the replacement or upgrading of assistive technology devices for eligible individuals only when the original system is no longer adequate because of the individual's disability, when there is a change in his or her vocational goal, when replacement is more cost effective than repairs or when the person will be unable to maintain employment without the replacement or upgrade. All other requirements of this policy continue to apply for replacement and upgrading.
- After providing rehabilitation technology, ACCES-VR will verify the adequacy and effectiveness of the service to meet the vocational needs of the individual.
Rehabilitation technology, in the form of assistive technology devices and services, may be the responsibility of agencies, programs, and employers as reasonable accommodations under the Americans with Disabilities Act and/or under Sections 503 and 504 of the Rehabilitation Act. For instance, schools, colleges and post-secondary programs often modify computers in their technology labs to allow access by students with disabilities. Likewise, an employer may provide an ergonomic chair to allow a worker to sit comfortably at the work site. ACCES-VR will not provide rehabilitation technology that is the responsibility of others as reasonable accommodations for individuals to fully participate in their programs, services or employment.
The qualifications of persons or organizations conducting assessments or providing rehabilitation technology for ACCES-VR will be approved on the basis of education, experience, ability to work successfully with individuals with disabilities, and ability to provide comprehensive reports of findings and recommendations upon which to develop a plan for rehabilitation technology services. Such individuals must:
- have successfully attained skills and knowledge in the delivery of rehabilitation technology services;
- document successful experiences in providing rehabilitation technology services to individuals with disabilities in their area of expertise;
- demonstrate the ability to assess and deliver rehabilitation technology services and communicate the results effectively orally and in writing in a clear, concise, logical and objective manner;
- maintain adequate liability insurance.
Assessment - ACCES-VR will establish maximum costs and duration for assessing an individual's need for rehabilitation technology services. ACCES-VR's payment includes the costs of assessing the individual in his or her customary or intended environment, as well as preparing the detailed report and recommendations required by ACCES-VR. Waiver requests to exceed these maximums must be fully justified and approved through ACCES-VR's waiver process.
Purchase - Because of the individualized nature of the rehabilitation technology services required by persons with disabilities, ACCES-VR has not established a maximum cost cap for the purchase of technology devices or systems. However, plans for rehabilitation technology services will be subject to various levels of review, based on the cost of the recommended service or device.
- Section 7(13), (23) and (24)
- Section 102(b)(1)(iv)(II)
- Section 103(a)(1) and (12)
- Technology - Related Assistance for Individuals with Disabilities Act of 1988
- 206.00 Individual Plan for Employment (IPE)
- 1125.00 Consumer Participation in the Cost of Services