Agencies | Governor
Virginia Regulatory Town Hall

Preliminary Draft Text

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Action:
Amend 22VAC45-70 and Repeal 22VAC45-80 to combine regulations
Stage: NOIRA

CHAPTER 70
REGULATIONS GOVERNING THE PROVISION OF SERVICES IN REHABILITATION TEACHING AND INDEPENDENT LIVING SERVICES

 

Part I
Introduction

22VAC45-70-10. Definitions.

The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Assessment" means the systematic evaluation or identification of the consumers' need for and ability to benefit from services.

"Blindness, legal blindness" means the condition as defined in §§ 63.1-142 and 63.1-166 of the Code of Virginia.

"Blind person" means an individual who has central visual acuity of 20/200 or less in the better eye, as measured with best correction, or a limitation in the field of vision in the better eye, such that the widest diameter of the visual field subtends an angle of 20 degrees or less (Code of Virginia §51.5-60).

"Consumer" means any person undergoing an assessment or receiving a service provided by the Rehabilitation Teaching Program of the Department for the Blind and Vision Impaired.

"DBVI" means the Department for the Blind and Vision Impaired.

"Deafblind person" means an individual who has central visual acuity of 20/200 or less in the better eye with corrective lenses, or a field defect such that the peripheral diameter of visual fields subtends an angular distance no greater than 20 degrees, or a progressive visual loss having a prognosis leading to one or both of the conditions; who has a chronic hearing impairment so severe that most speech cannot be understood with optimum amplification, or a progressive hearing loss having a prognosis leading to this condition; for whom the combination of impairments described in this definition cause extreme difficulty in attaining independence in daily life activities, achieving psychological adjustment or obtaining a vocation; and, who despite the inability to be measured accurately for hearing and vision loss due to cognitive or behavioral constraints or both, can be determined through functional and performance assessments to have severe hearing and visual disabilities that cause extreme difficulty in attaining independence in daily life activities, achieving psychological adjustment, or obtaining vocational objectives  (20 U.S.C. §1905 (2)(A) and 20 U.S.C. §1905 (2)(B)).

"Department" means the Department for the Blind and Vision Impaired.

"Financial needs assessment' means an assessment to consider the financial need of an individual who is applying for or receiving rehabilitation teaching and independent living services to determine the extent of the individual's participation in the costs of services.

"Independent living" means control over one's life based on the choice of acceptable options that minimize reliance on others in making decisions and performing everyday activities. This includes managing one's affairs, participating in day-to-day life in the community, fulfilling a range of social roles, making decisions that lead to self-determination, and the minimization of physical and psychological dependence on others.

"Individualized Written Rehabilitation Independent Living Program (IWRP) (Plan)" means a written program of rehabilitation teaching services identified during the assessment for each consumer individual determined eligible for services by this program.

"Reasonable expectation" means that rehabilitation teaching and independent living services are anticipated to significantly assist a consumer an individual to improve in improving his ability to function independently.

"Rehabilitation teaching" means the process of guiding and instructing a blind, visually impaired, or deafblind consumer person through an individualized plan of instruction designed to develop and raise the level of adaptive coping skills and functional independence.

"Severely visually impaired" means vision less than 20/70 in the better eye with correction or a field restricted to 70 degrees or less in the better eye.

Part II
Referral

22VAC45-70-20. Referral and application.

A. To be considered for rehabilitation teaching and independent living services, DBVI must obtain the following information must be obtained from the individual seeking services:

1. Name and address;

2. Date of birth and sex;

3. Disability; and

4. Date of referral.

The department DBVI shall expeditiously process persons the application of an individual who is referred for rehabilitation teaching and independent living services.

B. An DBVI shall conduct an assessment by the Department for the Blind and Vision Impaired is required of each person of the rehabilitation teaching and independent living needs of an individual who applies for rehabilitation teaching services. The assessment is limited to that information that is necessary to determine eligibility for rehabilitation teaching and independent living services consistent with 22VAC45-70-30 and to determine which rehabilitation teaching services are needed.

Part III
Eligibility

22VAC45-70-30. Eligibility for rehabilitation teaching and independent living services.

A. Eligibility requirements shall be applied without regard to sex, race, creed, color, or national origin. No group or individual shall be excluded or found ineligible solely on the basis of the type of disability or on the basis of age. No residence requirement shall be imposed that excludes from services any individual who is presently in the Commonwealth.

B. To be eligible for rehabilitation teaching and independent living services, a consumer an individual must have a visual limitation that constitutes or results in a substantial impediment to personal independent functioning. A consumer An individual has a visual limitation if one or more of the following criteria are met:

1. Legal blindness Is a blind person as described in the definition of "blind person" in 22VAC45-70-10;

2. Has distance vision of 20/100 20/70 to 20/200 distance vision in the better eye with correcting glasses or a field limitation to 30 degrees or less in the better eye, and if the person individual has been unable to adjust to the loss of vision, and if it is determined by the rehabilitation teacher that the person individual is in need of the specialized services available through the Department for the Blind and Vision Impaired's DBVI rehabilitation teaching and independent living program; or

3. Has Night night blindness or a rapidly progressive eye condition which, in the opinion of a qualified ophthalmologist or optometrist, will reduce the distance vision to 20/200 or less.

B C. A There is a reasonable expectation that rehabilitation teaching and independent living services will significantly assist the consumer individual to improve his ability to cope with blindness and to function more independently.

22VAC45-70-40. Eligibility determination.

Prior to or simultaneously with acceptance of a consumer an individual for rehabilitation teaching and independent living services, there shall be a determination of eligibility; a case narrative shall state the basis for the visual eligibility determination and a reasonable expectation that rehabilitation teaching and independent living services will shall significantly assist the consumer individual in achieving or maintaining functional independence. When a consumer an individual is determined ineligible for rehabilitation teaching services and independent living services, the rehabilitation teacher shall inform the consumer individual of the ineligibility determination, stating the reason or reasons. This may be done during a personal contact or by a letter.

Part IV
Services

22VAC45-70-60. The Individualized Written Rehabilitation Teaching and Independent Living Program (IWRP) (Plan).

Initial plan development.

1. The IWRP Plan shall specify the rehabilitation teaching and independent living services that the consumer individual and DBVI instructor rehabilitation teacher jointly determine are necessary to raise increase the individual's level of adaptive coping skills and functional independence.

2. The IWRP Plan shall be initiated after determination of eligibility and periodically updated to include additional rehabilitation teaching and independent living services that are needed by the consumer individual.

3. Rehabilitation teaching and independent living services shall be provided in accordance with IWRP the Plan.

22VAC45-70-70. Scope of rehabilitation teaching and independent living services.

Services provided through the rehabilitation teaching services and independent living program may include:

1. Counseling to determine the consumer's individual's need for specific rehabilitation teaching and independent living services.

2. Referral to and information regarding resources and programs, internal and external to DBVI, that which might benefit the consumer individual.

3. Counseling to assist the consumer individual to cope with visual vision loss.

4. Provision of low vision services in accordance with Regulations Governing Low Vision, 22VAC45-110.

5. Instruction in the following areas:

a. Personal management skills or activities of daily living;

b. Home management skills;

c. Communication skills, including reading and writing braille, typing, script writing, and use of electronic equipment and technology;

d. Other appropriate adaptive coping skills, i.e., to facilitate leisure and recreational activities; and

e. Information and instruction in the acquisition of and use of adaptive equipment.

Part V
Financial Participation

22VAC45-70-80. Financial participation in cost of services.

A. The Department for the Blind and Vision Impaired DBVI has elected to uniformly apply a financial needs assessment for persons receiving purchased rehabilitation teaching and independent living services and goods in the Commonwealth. Purchased services and goods may be provided at no cost to the recipient who is legally a blind person if the family's income is less than 100% 80% of the federally estimated median income for Virginia, and if the family's assets are less than 50% of the federally estimated median income as determined by the United States Department of Health and Human Services, Family Support Administration. The Department for the Blind and Vision Impaired will DBVI shall review and change its financial participation levels to match the above-referenced estimated median income level every third year annually.

B. There is shall be no financial participation in cost of services required for the assessment, counseling, low vision exams, information and referral, and instructional services provided through the rehabilitation teaching services and independent living program.

C. Consumers must be both legally blind and demonstrate financial need as determined by the financial needs assessment in order to receive any purchased services or goods other than a low vision exam.

D C. Allowable deductions from income.

1. Expenses that may be deducted from family income on the financial needs assessment are unusual medical expenses and the education of a consumer the individual or family member to attend a private or public educational facility. Medical expenses such as, including routine doctors' visits and hospital insurance premiums, may not be deducted.

2. When the consumer's individual's gross family income, liquid assets, or both, exceed the financial eligibility need requirement after allowable deductions have been considered, the consumer individual and his family are required to apply the excess toward the cost of those services provided by rehabilitation teaching and independent living services for which financial need is considered.

CHAPTER 80
PROVISION OF INDEPENDENT LIVING REHABILITATION SERVICES (REPEALED)

Part I
Introduction

22VAC45-80-10. Definitions. (Repealed.)

The following words and terms, when used in this chapter, shall have the following meaning unless the context clearly indicates otherwise:

"Center for independent living" means a program of services which offers a combination of independent living services for severely handicapped individuals or groups of severely handicapped individuals.

"Client Assistance Program" means a program located within the Department for Rights of the Disabled for the purpose of advising independent living rehabilitation applicants or clients about all available services under the Rehabilitation Act of 1973, as amended, and to assist them in their relationship with programs, projects, and facilities providing independent living rehabilitation services.

"Comparable services and benefits" means any appropriate service or financial assistance available from a program other than independent living to meet, in whole or in part, the cost of independent living services and which is under an individualized written rehabilitation program for a handicapped individual.

"Economic needs test" means a test used to consider the financial need of handicapped individuals for the purpose of determining the extent of their participation in the costs of services provided by this program.

"Independent living" means control over one's life based on the choice of acceptable options that minimize reliance on others in making decisions and performing everyday activities. This includes managing one's affairs, participating in day-to-day life in the community, fulfilling a range of social roles, making decisions that lead to self-determination, and the minimization of physical and psychological dependency on others.

"Individual with a severe disability" means an individual whose ability to function independently in a family or a community or whose ability to engage or continue in employment is so limited by the severity of his physical or mental disability that independent living rehabilitation services are required in order to achieve a greater level of independence in functioning in a family or a community or engaging or continuing in employment. Independent living rehabilitation services needed by an individual with a severe disability generally are appreciably more costly and of appreciably greater duration than vocational rehabilitation services that might be provided under 34 CFR 361.

"Individualized Written Rehabilitation Program (IWRP)" means an individualized written rehabilitation program for each individual being provided specified services by this program.

"Blindness, legal blindness" means the condition as defined in §§ 63.1-142 and 63.1-166 of the Code of Virginia.

"Reasonable expectation" means an expected outcome of services provision based on a judgment or decision made jointly by an applicant (or parent or guardian) and a case manager that the services requested and provided will enable the applicant to improve independent functioning.

"Severely visually impaired" means vision less than 20/70 in the better eye with correction or a field of vision restricted to 70 degrees or less in the better eye.

22VAC45-80-20. Referrals. (Repealed.)

The department shall expeditiously and equitably process referrals for independent living services.

A referral is any person for whom independent living rehabilitation services have been requested and for whom the worker has obtained the following information:

1. Name and address;

2. Date of birth and sex;

3. Disability or disabilities; and

4. Referral source and date of referral.

Part III
Eligibility and Ineligibility

22VAC45-80-30. Eligibility for independent living services. (Repealed.)

A. Eligibility requirements shall be applied without regard to sex, race, creed, color, or national origin. No group or individual shall be excluded or found ineligible solely on the basis of the type of disability or on the basis of age. No residence requirement shall be imposed which excludes from services any individual who is presently in the Commonwealth.

B. An assessment or evaluation by the Department for the Visually Handicapped (DVH) is required of each severely disabled person who applies for independent living services. The assessment is limited to that information necessary to determine whether the individual is eligible to be provided independent living services, and to determine which independent living services are needed.

C. All applicants for independent living services must be apprised of the services of the Client Assistance Program within the Department for Rights of the Disabled.

22VAC45-80-40. Basic conditions for eligibility. (Repealed.)

The following set forth criteria for basic eligibility:

1. The presence of legal blindness, which constitutes or results in a substantial impediment to the individual's ability to function independently in the family or community.

2. A reasonable expectation that independent living services will significantly assist the individual to improve his ability to function independently in his family or community or to engage in or continue employment.

3. Center for independent living. In addition to the basic conditions for eligibility contained in subdivisions 1 and 2 of this section, an individual must possess a second severe physical, mental, or emotional disability which constitutes or results in a substantial impediment to the individual's ability to function independently in a family or community.

22VAC45-80-50. Certification of eligibility. (Repealed.)

A. Prior to or simultaneously with acceptance of an individual with a severe disability for independent living rehabilitation services, there must be a certification that the individual has met the basic requirements specified in 22VAC45-80-40.

B. The certification is approved, dated, and signed by a DVH staff member.

22VAC45-80-60. Certification of ineligibility. (Repealed.)

A. When it is determined that independent living rehabilitation services cannot be expected to assist an individual to engage or continue in employment or to function more independently in family or community, a certification of ineligibility shall be signed and dated by a DVH staff member. A copy shall be provided to the individual simultaneously.

Such determination shall be made only after full consultation with the individual or, as appropriate, his guardian, or other representative. After affording a clear opportunity for this consultation, the DVH shall ensure notification in writing of the action taken and shall inform the individual of his rights and the means by which he may express and seek remedy for any dissatisfaction, including procedures for administrative review and fair hearings. The individual shall be provided a detailed explanation of the availability of the resources within the Client Assistance Program, Department for Rights of Virginians with Disabilities; and as appropriate, referral shall be made to other agencies and facilities, including, when appropriate, the vocational rehabilitation program.

B. Review of ineligibility determination. When DVH has certified the ineligibility of an applicant for independent living rehabilitation services because of a determination that these services cannot be expected to assist the individual to engage or continue employment or to continue to function more independently in family or community, the individual's ineligibility status will be reviewed annually. The review will not be conducted in situations where the individual has refused the review, is no longer present in Virginia, or the individual's whereabouts are unknown.

22VAC45-80-70. The Individualized Written Independent Living Rehabilitation Program (IWRP).

A. Initial plan development.

1. The IWRP shall be initiated and periodically updated for individually provided independent living services.

2. Independent living services shall be provided in accordance with the IWRP and approved by DVH staff member. A copy of the IWRP and any amendments shall be provided to the blind individual or his parents, guardian, or other representative.

3. The IWRP must be initiated after certification of eligibility for independent living services.

B. IWRP review. The IWRP shall be reviewed as often as necessary but at least on an annual basis. Each blind individual or his parents, guardian, or other representative shall be given an opportunity to review the IWRP and, if necessary, jointly modify the IWRP.

C. Determination of ineligibility under IWRP. If it becomes necessary to terminate services for any reason under an IWRP, the following conditions and procedures shall be met and carried out:

1. The decision shall be made only with the full participation of the blind individual, or his parents, guardian, or other representative, unless the individual has refused to participate, the individual is no longer residing in Virginia, or his whereabouts are unknown. When the full participation of the individual or a representative of the individual has been secured in making the decision, the reviews of the individual shall be recorded in the IWRP.

2. The basis for the ineligibility decision shall be recorded as an amendment to the IWRP, certifying that the provision of independent living services has not enabled the individual to function more independently in family or community or engaging or continuing employment. A certification of ineligibility is then completed.

3. There shall be at least an annual review of the ineligibility decision in which the individual is given an opportunity for full consideration in the reconsideration of the decision, except in situations where a periodic review would be precluded because the individual has refused services, has refused a periodic review, the individual is no longer living in Virginia, or his whereabouts are unknown. The first periodic review of the ineligibility decision shall be initiated by DVH staff. Any additional reviews shall be provided at the request of the individual.

D. Coordination with vocational rehabilitation, developmental disabilities and education program. The development of the IWRP for independent living services will be coordinated with the IWRP for vocational rehabilitation services if there is such a program, as well as with any individualized written rehabilitation program for the individual prepared under Developmental Disabilities Assistance and Bill of Rights Act or with any individualized education program for the individual.

Part IV
Scope of Services

22VAC45-80-80. Scope of independent living rehabilitation services for individuals.

The following independent living rehabilitation services may be provided if deemed necessary to the independence of the individual:

1. Intake counseling to determine the severely handicapped individual's need for specific independent living services;

2. Counseling services, including psychological counseling, psychotherapeutic counseling, peer counseling, and related services;

3. Advocacy for disabled individuals with respect to legal and economic rights and benefits;

4. Housing incidental to the provision of independent living rehabilitation service—this includes assistance in finding adequate housing and minor modifications to make housing accessible;

5. Independent living skills, counseling, and training:

a. Special tutorial and training services;

b. Orientation and mobility;

c. Special communication skills for deaf-blind;

d. Interpreter services for deaf-blind;

e. Rehabilitation teaching; and

f. Education and training necessary for living in the community and consumer education.

6. Transportation associated with the provision of essential independent living services;

7. Reader services;

8. Recreation activities—group and individual;

9. Attendant care—attendant for short-term care--to enable a multihandicapped blind person who has potential for acquiring skills to expand his independent living skills;

10. Interpreter services for deaf-blind;

11. Services to members of a blind individual's family when needed for improving the individual's ability to live and function more independently;

12. Provision of physical, occupational, and speech therapy;

13. Purchase of special adaptive aids and appliances;

14. Vocational and other training services;

15. Information, referral, and outreach;

16. Other programs and services necessary to provide resources, training, counseling, services, or other assistance of substantial benefit on promoting the independence, productivity, and quality of life for the severely handicapped individual; and

17. Any appropriate preventive services necessary to decrease the future needs of a blind individual assisted under the program for similar services.