ESBD_548201_1786394455072_Attachment 06 – Chapter 04 and Sample Forms.pdf

3202600194 Employment Services - Attachment 06

Joe Esparza, Chairman and Commissioner

Representing Employers

Alberto Treviño III, Commissioner

Representing Labor

Brent Connett, Commissioner

Representing the Public

Steve Pier, Executive Director

Attachment 06 – Chapter 04 and Sample Forms

For

3202600194 Employment Services

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Contents

Chapter 4: Employment Assessments

4.1 Overview of Employment Assessments

4.2 Staff Qualifications

4.2.1 Vocational Evaluator

4.2.2 Vocational Evaluator Aide

4.2.3 Environmental Work Assessment Evaluator

4.2.4 Career Planning Assessment Evaluator

4.3 Vocational Evaluation

4.3.1 Vocational Evaluation Service Description

4.3.2 Process and Procedure

4.3.3 Outcomes Required for Payment

4.4 Vocational Evaluation - Situational Assessments and Work Samples

4.4.1 Vocational Evaluation - Situational Assessments and Work Samples

Service Description

4.4.2 Process and Procedure

4.4.3 Outcomes Required for Payment

4.5 Environmental Work Assessment

4.5.1 Environmental Work Assessment Service Description

4.5.2 Process and Procedure

4.5.3 Outcomes Required for Payment

4.6 Career Planning Assessment

4.6.1 Career Planning Assessment Service Description

4.6.2 Career Planning Assessment Process and Procedure

4.6.3 Career Planning Assessment Outcomes Required for Payment

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4.7 Employment Assessments Service Fees

4.8 Resources

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VOCATIONAL REHABILITATION STANDARDS

FOR PROVIDERS MANUAL

CHAPTER 4: EMPLOYMENT ASSESSMENTS

Contract Subject: VR Employment Services, VR Vocational Evaluation

The contractor and contractor staff that provide services described in this chapter also must comply with the requirements in Chapters 1–3 of the VR

Standards for Providers manual.

4.1 OVERVIEW OF EMPLOYMENT ASSESSMENTS

Employment assessments are tools that evaluate a customer's work and training background, general functional capacities, and social behavior.

Employment assessments are designed to determine a customer's present and future vocational potential and to evaluate the customer's employment-related strengths and limitations.

This chapter includes information on the following employment-related assessment services:

• Vocational Evaluation

• Situational Assessments and Work Samples

• Environmental Work Assessment (EWA)

• Career Planning Assessment (CPA)

All fees for services described in this chapter can be found in VR-SFP 4.7

Employment Assessments Service Fees.

Premium payments may be available for some employment assessment services. Premium payments are paid after all deliverables for the service have been achieved. For more information about premiums, refer to VR-SFP Chapter

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20: Premiums.

Any request to change a Service Description, Process and Procedure, or

Outcomes Required for Payment must be documented and approved by the VR director, using the VR3472, Contracted Service Modification Request for

Vocational Assessments form, before the change is implemented. The approved VR3472 must be maintained in the provider’s customer case file. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification

Request.

4.2 STAFF QUALIFICATIONS

Before services are provided to customers, the service provider's director must approve VR3455, Provider Staff Information form, completed by each staff member, and submit the approved forms to the provider's assigned VR regional quality assurance specialist or designee. The staff member must document the customer's qualifications on the VR3455, Provider Staff

Information form, and provide evidence of meeting all qualifications by providing, for example, transcripts, diplomas, reference letters, credentials, and/or licenses.

It is preferred, but not required, that the provider staff have a varied and successful work history and experience working with individuals with disabilities.

Each individual who administers vocational tests, batteries, and/or other instruments requiring certification must be certified by the appropriate entity.

The provider must give the VR regional quality assurance specialist or designee assigned to the contract an up-to-date written list of vocational tests, batteries, and/or other instruments when the contract is executed or renewed, and any time instruments are added or deleted. The list must:

• identify each instrument used to evaluate customers; and

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• describe what each instrument is intended to measure.

4.2.1 Vocational Evaluator

A vocational evaluator must hold:

• a master's degree in vocational evaluation; or

• a master's degree in a related field (for example, psychology, sociology, or education) and have two years of full-time experience as a vocational evaluator; or

• a bachelor's degree in a related field (for example: psychology, sociology, industrial arts, etc.) and have three years of full-time experience as a vocational evaluator; or

• a valid psychologist's license.

A vocational evaluator cannot supervise more than two vocational evaluator aides.

4.2.2 Vocational Evaluator Aide

A vocational evaluator aide must have:

• one year of full-time work experience directly related to vocational evaluation; or

• a bachelor's degree in a related field.

The vocational evaluator aide must work under the supervision of the vocational evaluator.

4.2.3 Environmental Work Assessment Evaluator

The environmental work assessment evaluator must have a current autism endorsement from the University of North Texas Workplace Inclusion and

Sustainable Employment (UNTWISE).

Information on the UNTWISE Texas credentials and endorsements can be found at http://wise.unt.edu/crptraining.

https://wise.unt.edu/crptraining

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No waiver or exceptions can be used to waive the autism endorsement requirement.

4.2.4 Career Planning Assessment Evaluator

The CPA evaluator must have:

• a current University of North Texas Workforce Inclusion and Sustainable

Employment (UNTWISE) Supported Employment Specialist credential;

and

• a high school diploma or GED; however, a bachelor's degree in rehabilitation, business, marketing, or related human services is preferred.

4.3 VOCATIONAL EVALUATION

This section outlines the requirements and processes for vocational evaluations. It defines the scope of the evaluation, the methods used to assess work characteristics, and the expected outcomes for both the customer and the vocational rehabilitation program.

4.3.1 Vocational Evaluation Service Description

Vocational evaluation is an assessment of an individual's work and training background, general functional capacities, and social and/or behavioral characteristics. The vocational evaluation must contain a detailed description of the customer's behaviors and must describe any implications for the workplace. The evaluation must be designed to determine the customer's present and future vocational potential. The evaluation also must include an assessment of the customer's employment-related strengths and limitations.

Vocational evaluations cannot be conducted remotely.

The evaluation must:

• be conducted by the vocational evaluator;

• document up to six hours of assessment per day; and

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• result in a vocational objective or alternative vocational objectives being identified by the vocational evaluator.

The following techniques are generally used to establish and measure a customer's work characteristics.

4.3.1.1 Standardized Tests

Standardized tests include tests that:

• measure the customer's academic achievement, cognitive abilities, aptitude, personality, vocational interests, sensory and/or motor skills, and independent living skills; and

• compare the individual's performance with the performance of an appropriate sample population.

All test instruments must be appropriate for use with the target population, including appropriate norms, adaptations, and accommodations.

4.3.1.2 Work Samples

Work samples provide a close simulation of an actual industrial task, business operation, or component of an occupational area. Work samples might not be necessary for all vocational evaluations. However, when deemed necessary by the vocational evaluator or when requested on the referral form or service authorization, work samples must be completed.

The activities involved in conducting a vocational evaluation and preparing a report include developing a case history, assessing information, performing standardized tests, and providing work samples, when appropriate.

The customer's case history must include:

• contact information;

• educational background;

• employment history;

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• medical history;

• social history;

• psychological and/or emotional history and current stability;

• daily living activities; and

• independent living skills.

The following areas must be evaluated during the vocational evaluation:

1. Cognitive abilities, such as:

o learning ability, including attention, concentration, comprehension, memory and/or retention, creativity, and conceptualization;

o communication skills and interaction with others;

o ability to follow oral and written instructions;

o work organization and planning; and o spatial concepts

2. Academic achievements (grade level) in reading, writing, spelling, and mathematics

3. Physical abilities, such as:

o fine motor abilities, including bimanual dexterity, speed, coordination, and strength;

o gross motor abilities, including strength, balance, and coordination; and o stamina and/or physical tolerance and endurance

4. Sensory abilities (identifying preferred learning style—visual, auditory, or tactile), such as the use of:

o residual vision;

3202600194 Employment Services - Attachment 06 Page 10 of 28 o auditory processing and sound localization; and o tactile perception

5. Aptitudes and vocational interests and/or exploration, such as:

o specific equipment and technical skills; and o preferred vocational interests compared to abilities

6. Behavioral observations and work habits, such as:

o general and work-related behaviors;

o self-image (pertaining to self and work);

o appearance (for example, grooming, hygiene, appropriate clothing for the work setting);

o motivation and attitude toward work;

o attendance and punctuality;

o travel to and from the work setting (for example, access to dependable transportation, understanding how to use transportation);

o orientation within the work setting (for example, showing the customer where the work area is, restrooms, break rooms, supervisor's location);

o work stability (including attention to work despite environmental distractions or changes);

o work productivity and quality;

o acceptance of supervision (accepting and responding to suggestions, corrections, and general feedback);

o responsibility for materials and work;

o adherence to workplace standards (for example, employee policies, 3202600194 Employment Services - Attachment 06 Page 11 of 28 rules, and schedules);

o safety standards (understanding and adhering to specific workplace safety standards);

o impulse control (for example, predictable behavior and adequate self-control);

o stress tolerance;

o cognitive flexibility;

o persistence (following through on a work task to completion);

o initiative (working independently);

o job-seeking skills; and o the customer's potential to benefit from VR services.

4.3.2 Process and Procedure

An employment service provider receives a VR5000, Referral for Provider

Services, and a service authorization.

The VR5000, Referral for Provider Services, includes any documentation that will:

• prepare the provider to better work with the customer;

• indicate the reasons for referral; and

• include specific questions to be addressed during the evaluation.

The scope of each evaluation is determined based on the customer's individual needs. There are no fixed guidelines regarding the number of days required to complete an evaluation. Generally, an evaluation is expected to take one to eight days. The VR counselor determines the appropriate length of the evaluation based on the assessment of the customer's individual needs and circumstances.

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The vocational evaluator's job responsibilities during the evaluation are to:

• remain on-site to supervise all services, including the evaluation;

• supervise qualified vocational evaluator aides and maintain the following ratios:

o One evaluator to no more than six customers without an aide o One evaluator and one aide to no more than 10 customers o One evaluator to no more than three customers with blindness and/or visual impairment o One evaluator and one aide to no more than six customers with blindness and/or visual impairment

• provide written proof, through attendance records made available on request, that the correct ratio of customers to vocational evaluators and vocational evaluator aides is maintained;

• identify appropriate and inappropriate behaviors using existing records, personal observations, and conversations with the VR counselor, the customer, family members, and others;

• prepare an electronic VR1837, Report for Vocational Evaluation, or an electronic report with all required elements; and

• review the customer's vocational interests, strengths, challenges, and recommendations with the customer, the customer's representation, if any, and the VR counselor, when requested on the VR5000, Referral for

Provider Services, or on the service authorization.

4.3.3 Outcomes Required for Payment

Vocational evaluation reports must be submitted using VR1837, Report for

Vocational Evaluation, or an electronic report containing all required elements outlined in the Service Description and noted in the VR1837. The cumulative

3202600194 Employment Services - Attachment 06 Page 13 of 28 findings of a vocational evaluation must be submitted no later than 10 working days from the last day of the evaluation.

The report must describe the customer's behavior and must stress the vocational implications of the following factors:

• results of the evaluator's findings and observations specified in the

Service Description;

• potential for competitive integrated employment, or the reasons that competitive integrated employment is not appropriate, when applicable;

• job recommendations related to the current job market using the

Standard Occupational Classification (SOC) codes for the customer's geographic area;

• specific training options that match the customer's capabilities; and

• specific job modifications and/or accommodations necessary to achieve the employment goal

The VR1837, Report for Vocational Evaluation, or the electronic report must contain the signature of the vocational evaluator who conducted the evaluation. For more information, refer to VR-SFP sections 3.2.14

Documentation and 3.2.16 Signatures.

When requested on VR5000, Referral for Provider Services, or on the service authorization, the vocational evaluator must complete a feedback session with the customer, the customer's representative, if any, and the VR counselor, to review the evaluator's recommendations and the customer's vocational interests, strengths, and challenges.

To request partial payment for work that has not been completed in its entirety, a VR3472, Contracted Service Modification Request, may be submitted. Justification for why the vocational evaluation cannot be completed in its entirety must be included on VR3472, Contracted Service Modification

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Request.

A partial work product, such as a report and documentation of the time spent completing the deliverables, must be submitted with the VR3472, Contracted

Service Modification Request, and must be approved by the TWC-VR director before any partial work is invoiced. The achievement of required deliverables and the hours spent is evaluated on a case-by-case basis. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification Request.

4.4 VOCATIONAL EVALUATION - SITUATIONAL ASSESSMENTS AND

WORK SAMPLES

Situational assessments and work samples provide valuable insights into a customer's ability to succeed in competitive integrated employment. The following sections outline the specific requirements for these services, focusing on the data and observations needed to determine the best path forward for the customer.

4.4.1 Vocational Evaluation - Situational Assessments and Work Samples

Service Description

A Vocational Evaluation must be completed before the Situational Assessment and Work Samples are administered.

The Situational Assessment and Work Samples are tools to help the customer and VR counselor determine long-term goals related to finding competitive integrated employment. The Situational Assessments and Work Samples service must consist of the three situational assessments and at least four work samples. The work samples cannot be the same as the ones used in the vocational evaluation.

The evaluator's observations and the customer's career goal, interests, preferences, and experiences are used to determine the type of job and support services necessary for the customer to find competitive integrated employment.

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Vocational Evaluations-Situational Assessments and Work Samples are provided in person and cannot be conducted remotely.

4.4.1.1 Situational Assessments

A situational assessment is conducted at three or more competitively integrated work sites within a business or industry setting in the community.

The vocational evaluator must observe the customer for a minimum of two hours per competitive integrated work site.

The community-based assessments allow the customer to explore his or her ability to perform a variety of job tasks and help the customer make informed choices about the type of work environment and job tasks that he or she prefers.

Situational Assessments:

• assess the customer's ability to perform real job tasks that exist in industry (whether paid or unpaid);

• demonstrate the customer's ability to do the tasks successfully; and

• assess job tasks that have been carefully documented to show adherence to industrial norms.

Examples of the sites at which situational assessments may be conducted include production lines, jobsites, and areas within a provider's established workplace.

4.4.1.2 Work Samples

A minimum of four Work Samples that were not completed in the vocational evaluation must be completed. Work samples provide a close simulation of an actual industrial task, business operation, or component of an occupational area.

The VR1838, Situational Assessment and Work Sample Report, must include documented examples of the customer's behavior and the vocational

3202600194 Employment Services - Attachment 06 Page 16 of 28 implications of relevant factors, including:

• the reason for referral, including the customer's response to specific questions asked by the referring VR counselor;

• the customer's assets and capabilities;

• the customer's disability and limitations (or special considerations);

• the customer's physical capacities;

• the results of medical examinations or related information obtained during evaluation, if appropriate;

• the results of the evaluator's findings and observations specified in the

Service Description;

• the potential for competitive integrated employment or the reasons that competitive integrated employment is not appropriate, when applicable;

• the job recommendations related to the current job market using the

SOC codes for the customer's geographic area;

• the specific training options that match the customer's capabilities; and

• the specific job modifications and/or accommodations necessary for the customer to achieve the employment goal.

4.4.2 Process and Procedure

An employment service provider receives a VR5000, Referral for Provider

Services, and a service authorization.

The VR5000, Referral for Provider Services, includes any documentation that:

• will prepare the provider to better work with the customer;

• indicates the reasons for referral; and

• poses specific questions to be addressed in the assessment.

The scope of each Situational Assessment and Work Sample is determined by

3202600194 Employment Services - Attachment 06 Page 17 of 28 the customer's individual needs.

The vocational evaluator's job responsibilities during the evaluation are the following:

• Remain on-site to supervise the provision of all services, including the

Situational Assessment and Work Samples service.

• Supervise qualified vocational evaluator aides and maintain the following ratios:

o One evaluator to no more than six customers without an aide o One evaluator and one aide to no more than 10 customers o One evaluator to no more than three customers with blindness and/or visual impairment o One evaluator and one aide to no more than six customers with blindness and/or visual impairment

• Provide written proof, through attendance records made available on request, that the correct ratio of customers to trainers and vocational evaluator aides is maintained.

• Identify appropriate and inappropriate behaviors using existing records, personal observations, and conversations with the VR counselor, customer, family members, and others.

• Prepare the electronic report or the electronic VR1838, Situational

Assessment and Work Sample Report.

• Review the customer's vocational interests, strengths, challenges, and recommendations with the customer, the customer's representative, if any, and the VR counselor, when requested on the VR5000, Referral for

Provider Services, and/or on the service authorization.

4.4.3 Outcomes Required for Payment

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The situational assessment and work sample reports must be submitted using a VR1838, Situational Assessment and Work Sample Report, and this must be submitted no later than 10 working days from the last day of the assessment.

The report must describe the customer's behavior and must stress the vocational implications of the relevant factors outlined below:

• The results of the evaluator's findings and observations specified in the

Service Description

• The potential for competitive integrated employment or the reasons that competitive integrated employment is not appropriate, when applicable

• The job recommendations related to the current job market using the

SOC codes for the customer's geographic area

• The specific training options that match the customer's capabilities

• Any specific job modifications and/or accommodations necessary

The VR1838, Situational Assessment and Work Sample Report, must contain the signature of the vocational evaluator who conducted the assessment. For more information, refer to VR-SFP sections 3.2.14 Documentation and 3.2.16

Signatures.

When requested on VR5000, Referral for Provider Services, or on the service authorization, the vocational evaluator must complete a feedback session with the customer, the customer's representative, if any, and the VR counselor, to review the evaluator's recommendations and the customer's vocational interests, strengths, and challenges.

To request partial payment for work that has not been completed in its entirety, a VR3472, Contracted Service Modification Request, is submitted.

Justification for why the vocational assessment cannot be completed in its entirety must be included on the VR3472, Contracted Service Modification

Request form.

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A partial work product, such as a report and documentation of time spent in completing the deliverables, must be submitted with the VR3472, Contracted

Service Modification Request form. The form must be approved by the VR director before any partial work is invoiced. The achievement of required deliverables and hours spent is evaluated on a case-by-case basis. For more information, refer to VR-SFP 3.4.11 Contracted Services Modification Request.

4.5 ENVIRONMENTAL WORK ASSESSMENT

The Environmental Work Assessment (EWA) offers a specialized approach to understanding how a customer's performance is affected by various workplace factors. The following sections detail the EWA service, including its purpose, target population, and specific assessment procedures.

4.5.1 Environmental Work Assessment Service Description

An EWA is a diagnostic tool that assesses how the customer responds to variables in a work environment. The EWA is an accurate assessment of the correlations between a customer's performance and environmental variables and is critical to the customer's ability to find and maintain employment.

Results of the assessment identify the variables in a work environment that affect the customer's ability to function at his or her full potential. The EWA is provided in person and cannot be conducted remotely.

The EWA is most appropriate for a customer who:

• has a neurodevelopmental disorder that significantly affects him or her;

• has a history of behavior that varies depending on the environment; and

• may benefit from an evaluation that assesses how his or her neurodevelopmental disorder may manifest in a work setting.

The EWA evaluator assesses the customer's skills in at least three work environments that align with his or her interests and the employment goal in the customer's individualized plan for employment (IPE), when known. Each

3202600194 Employment Services - Attachment 06 Page 20 of 28 environment is assessed for a minimum of two hours.

Exceptions

The following exceptions are allowed when conducting an EWA:

• Conducting an EWA in another environment—Environments that accurately mimic the intended work environment are acceptable, when an intended work environment is not available or when another environment is in the best interest of the customer. For example, if the intended work environment is loud, busy, and bright, then the alternate environment in which the assessment is conducted must mimic those same variables in order for the assessment to be valid.

• Assessing three environments during an EWA—One environment can be used twice, if changing the day or time would significantly alter the environmental variables. For example, the environment in a grocery store on a Saturday at 1:00 p.m. is significantly different from the environment at the same grocery store on a Sunday at 11:00 p.m. The assessment must be conducted in an environment that accurately mimics the intended work environment.

• Spending at least two hours per environment—If appropriate, assessments in the same location can occur over time. For example, a customer can go to an environment for one hour on one day and go to the same environment for the second hour on another day.

• Reviewing the results of the EWA with the customer in person—If an in-person meeting with the customer is not possible, the VR counselor may approve a teleconference to review the EWA results. The written approval must be kept in the evaluator's and the customer's case files.

The EWA may be conducted during any phase of the VR process, but it is typically conducted during the development of the IPE. The EWA is not a

Vocational Evaluation or a Career Planning Assessment.

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For more information on fees for the EWA, refer to the fee chart.

4.5.2 Process and Procedure

An EWA evaluator must have a current bilateral contract for conducting EWAs before providing the service.

The VR counselor sends VR1879, Referral Form for Services for

Neurodevelopmental Disorders, and a service authorization to the provider.

The provider may request additional documentation from the VR counselor, such as case notes on psychological, vocational, or medical evaluations, that will prepare the provider to better work with the customer.

Billable time spent with the customer includes time spent on a combination of the following:

• Gathering information with the VR counselor and other pertinent professionals related to the customer (conducted by email, phone, or in person)

• Reviewing records

• Visiting the customer's home

• Observing the customer

• Planning for assessments at each work site

• Assessing the customer at each site

• Completing the report and recording the scores

• Meeting with the customer to review the assessment results, provide feedback, and plan next steps

After the EWA is completed, all results must be documented on the

• VR1877A, Environmental Work Assessment Report Part A;

• VR1877B, Environmental Work Assessment Report Part B (when printing the results of the EWA Part B, use the print option "print entire

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• VR1877C, Environment Work Assessment Signature Page Part C; and

• VR1878, Environmental Work Assessment Time Log.

The EWA evaluator must review the results of the EWA with the customer in person. The results must be presented to the customer in color; for example, printed with colored ink or viewed on a monitor that displays color.

4.5.3 Outcomes Required for Payment

The EWA evaluator documents in descriptive terms all the information required in the Service Description on VR1877, Environmental Work Assessment, parts

A, B, and C, and VR1878, Environmental Work Assessment Time Log, demonstrating evidence that the customers:

• interests, assets, and abilities in work and nonwork areas were explored, identified, and summarized;

• personal, social, school, and medical histories were collected;

• self-assessment includes the customer's score of the 40 basic skills;

• skills were assessed in three environments related to the following four domains, after the environmental demands were identified and rated:

o Basic and social communication o Problem solving and executive functioning o Advanced and social communication o Self-regulation and emotional intelligence

The EWA evaluator documents in descriptive terms all the information required in the Service Description on the VR1878, Environmental Work Assessment

(EWA) Time Log, recording:

• each session held with the customer;

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• locations at which the sessions were held; and

• whether the time spent was direct or indirect, as well as whether:

o no more than eight hours were spent on indirect services; and o no fewer than 12 hours were spent on direct services.

Payment is authorized when the EWA evaluator submits a complete, accurate, signed, and dated:

• VR1877A, Environmental Work Assessment (EWA) Report, Part A

(Summary);

• VR1877B, Environmental Work Assessment (EWA) Report, Part B

(Results);

• VR1877C, Environmental Work Assessment (EWA) Report, Part C

(Signature Page);

• VR1878, Environmental Work Assessment (EWA) Time Log; and

• invoice.

This is an outcome-based service; therefore, VR will not pay unless all topics in the Service Description and service authorization are addressed. For more information, refer to VR-SFP sections 3.2.14 Documentation and 3.2.16

Signatures.

4.6 CAREER PLANNING ASSESSMENT

The Career Planning Assessment (CPA) is a functional assessment designed to inform future employment planning. The following sections detail the CPA service, its process, and the expected outcomes.

4.6.1 Career Planning Assessment Service Description

The Career Planning Assessment (CPA) is a functional assessment designed to evaluate the customer's work skills, determine support needs, and provide information needed to plan for future employment. The CPA is completed by

3202600194 Employment Services - Attachment 06 Page 24 of 28 the CPA evaluator using an individualized and supportive approach. The CPA evaluator conducts the assessment using a variety of strategies, including exploration and work skills assessment. During the CPA, the CPA evaluator conducts interviews, observes the customer in natural environments such as at home or in the community, and assesses the customer in three integrated work settings. The CPA includes multiple visits, which consist of a minimum of three hours of home and community exploration and a minimum of six hours of career exploration and work skills assessments. Interviews with the customer and his or her circle of support may be done in person or remotely.

All observations and assessments of the customer's skills and abilities in the community or a work environment must be done in person only.

4.6.2 Career Planning Assessment Process and Procedure

The following subsections outline the specific steps and requirements for conducting a Career Planning Assessment (CPA).

4.6.2.1 Referral

The VR counselor sends VR5000, Referral for Provider Services, and a SA to the CPA evaluator. The VR counselor should provide relevant documentation, such as case notes, psychological reports, and vocational and/or medical evaluations, that prepare the provider to assess the customer.

If an EWA is conducted before the CPA, payment for the CPA may be prorated or the CPA may be purchased fully as determined by the VR counselor. When payment for the CPA is prorated, the work skills assessment section of the CPA does not need to be completed. However, if circumstances dictate, such as significant changes in the customer’s life or a long amount of time between assessments, an entire CPA may be purchased a second time with an approved

VR3472, Contracted Service Modification Request for Vocational Assessments, before the referral.

To prorate payment for the CPA, VR staff issues a prorated service

3202600194 Employment Services - Attachment 06 Page 25 of 28 authorization (SA) to the provider using the fee listed in VR-SFP 4.7:

Employment Assessments Fee Schedule. On the VR1630, Career Planning

Assessment, the provider must complete all sections except for the three work skills assessments.

At the time of referral, the VR counselor authorizes disability-related premiums, if appropriate. For more information on premiums, refer to VR-SFP

Chapter 20: Premiums.

4.6.2.2 Home and Community Exploration

The CPA evaluator conducts home and community exploration with the customer by observing the customer in natural environments, such as at home and in the community. The CPA evaluator must spend a minimum of three hours conducting home and community exploration with the customer.

During home and community exploration, the CPA evaluator conducts interviews with the customer and members of the customer’s circle of support and observes the customer engaging in typical activities within home and community settings.

When conducting home and community exploration, the CPA evaluator collects information on the customers:

• independent living skills and household responsibilities;

• circle of support;

• financial resources;

• community and long-term support resources;

• transportation access and abilities;

• education and learning style; and

• other pertinent information.

4.6.2.3 Career Exploration and Work Skills Assessment

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The CPA evaluator spends at least six hours conducting the career exploration and work skills assessment.

During career exploration, the CPA evaluator administers career exploration activities to explore the customer’s vocational interests and preferred employment conditions. Career exploration activities should entail researching industries or fields, exploring employers in the local community, discussing job tasks and environmental preferences, reviewing education and experience requirements, and/or reviewing outlook and wages.

During the work skills assessment, the CPA evaluator observes the customer in three integrated work settings that align with the customer’s interests and allow for an assessment of the customer’s abilities and skills. The work skills assessment must take place at more than one location or multiple environments within one location when necessary.

The CPA evaluator monitors the customer closely during the work skills assessment, documenting the tasks performed, functional abilities and work tolerance, strengths and abilities, support needs, and likes and dislikes. At the work site, the customer completes work tasks, tours the work site, observes employees performing tasks, and/or conducts informational interviews with staff.

After the CPA is completed, the CPA evaluator documents all results on

VR1630, Career Planning Assessment.

The VR counselor reviews the CPA and determines the next steps needed for the customer to achieve competitive integrated employment. The assessment may be reviewed with the CPA evaluator, the VR counselor, and the customer during a subsequent meeting (for example, during the Supported Employment

Plan meeting).

4.6.3 Career Planning Assessment Outcomes Required for Payment

The CPA evaluator:

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• completes a minimum of three hours of home and community exploration;

• completes a minimum of six hours of career exploration and work skills assessment; and

• documents all information required in the Service Description and

Process and Procedures on VR1630.

Payment is made upon receipt of:

• a signed, complete, and accurate VR1630; and

• an invoice.

4.7 EMPLOYMENT ASSESSMENTS SERVICE FEES

A provider may not collect money from a VR customer or the customer's family in excess of VR service fees for any service charged. If VR services and another resource are used to paying for a service for a customer, the total payment must not exceed the fee specified in the VR Standards for Providers manual.

Each employment assessment below must only be purchased one time per customer.

Employment

Assessments

Unit

Rate Comment

Vocational Evaluation $288 per day

• Minimum hours per day is two with no more than six hours

• Maximum payment allowed is $1,440.

• Incomplete assessments with the report are paid at $48 per hour, when

VR3472, Contracted Service

3202600194 Employment Services - Attachment 06 Page 28 of 28

Employment

Assessments

Unit

Rate Comment

Modification Request for Vocational

Assessments is approved by the VR division director

Vocational Evaluation

- Situational

Assessments and

Work Samples

$864

• Paid only on receipt of a complete report, with all deliverables addressed

Environmental Work

Assessment $1213

• Paid only on receipt of a complete report, with all deliverables addressed

Career Planning

Assessment $1,194

• Paid only upon receipt of a complete report, with all deliverables addressed

Prorated Career

Planning Assessment $643

• Paid only when EWA has been completed and paid

Premium payments may be available for some employment assessment services. Premiums payments are paid after all deliverables for the service have been achieved. For more information, refer to VR-SFP Chapter 20:

Premiums.

4.8 RESOURCES

• Case Study for Career Planning Assessment (CPA):

o CPA Case Study-Marsha o VR1630 CPA Example https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.twc.texas.gov%2Fsites%2Fdefault%2Ffiles%2Fvr%2Fdocs%2Fse-cpa-case-study-twc.docx&wdOrigin=BROWSELINK https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.twc.texas.gov%2Fsites%2Fdefault%2Ffiles%2Fvr%2Fdocs%2Fse-case-study-vr1630-twc.docx&wdOrigin=BROWSELINK

VR1630 (02/23) Career Planning Assessment Page 1 of 6

Texas Workforce Commission Vocational Rehabilitation Services

Career Planning Assessment VR Case Information

Customer Name: Case ID:

Service Authorization (SA) Number:

Overview of Career Planning Assessment Activities

The CPA includes multiple visits, which consist of at least 3 hours of home and community exploration (HCE) and at least 6 hours of career exploration and work skills assessment (CE-WSA). If both HCE and CE-WSA are provided in one session, record time as separate entries.

Date: Number of hours: Type of Visit Description of activities with customer:

HCE CE-WSA

HCE CE-WSA

HCE CE-WSA

HCE CE-WSA

HCE CE-WSA

HCE CE-WSA

HCE CE-WSA

HCE CE-WSA

HCE CE-WSA

Home and Community Exploration Include the customer’s guardian, parents, and any other supports, as needed Independent Living Review Customer lives in: Own Home/Apartment Parent’s Home Group Home Institution Other, describe:

Does the customer plan to live at this location once employed? Yes No To be determined

Does the customer have any responsibilities related to:

Childcare? Yes No Eldercare? Yes No If yes to either, describe:

What are the customer’s household responsibilities?

Does the customer require any monitoring or help with daily living skills at home (e.g., prompts to shower, medication management, help cooking and cleaning)?

What is the customer’s daily routine and how can employment fit into that routine?

Select any devices the customer utilizes that might help with employment:

NA-Customer does not use any Cell Phone iPad/Tablet Computer/Laptop Watch Alarm Clock Headphones Other device:

List any medical equipment used, such as hearing aids, insulin pump, wheelchair, etc.:

VR1630 (02/23) Career Planning Assessment Page 2 of 6

Is the customer involved in any community activities or have interest in participating in community activities?

What are the customer’s interests and hobbies?

Describe how the customer’s interests and hobbies might transfer to any careers:

Circle of Support Name: Relationship:

Phone: Email:

Describe what supports the individual currently provides or could provide in the future:

Name: Relationship:

Phone: Email:

Describe what supports the individual currently provides or could provide in the future:

Name: Relationship:

Phone: Email:

Describe what supports the individual currently provides or could provide in the future:

List any community resources used by the customer or any community resources the customer is interested in using:

Financial Resources Does the customer have any financial support from family or friends (e.g., assistance with housing, food)?

Does the customer live in public housing? Yes No If yes, how will the housing be impacted by earnings from a job?

Does the customer manage their own money? Yes No If no, who assists the customer with money management?

Does the customer have a bank account? Yes No Use the BPQY provided by the VR counselor when appropriate to answer the questions below.

Does the customer receive social security benefits? No Yes If yes, complete the following:

Benefits receiving:

Supplemental Security Income Social Security Disability Insurance Social Security Retirement Childhood Disability Beneficiary/Disabled Adult Child Disabled Widow/Widower

Representative Payee: No Yes, list name:

Does customer participate in any of the Social Security Administration work incentives?

No Yes, describe details of the SSA work incentives:

For more information, refer to Social Security Administration Work Incentives.

Home and Community Based Service Waiver Information Does the customer receive one of the following HCBS Waivers? Yes No If yes, complete the following:

HCS CLASS TxHmL DBMD YES STAR+PLUS Waiver https://www.ssa.gov/disabilityresearch/workincentives.htm

VR1630 (02/23) Career Planning Assessment Page 3 of 6

Medically Dependent Children’s Waiver under STAR Kids Name and Contact Information for Service Coordinator/Case Manager:

Name and Contact Information for Waiver Provider:

For more information, refer to Home and Community Based Services Information.

Transportation Describe the customer’s options to travel to and from work (e.g., family, Uber, biking, etc.):

Describe any assistance the customer will need traveling to and from work:

Other Pertinent Information Describe any other pertinent information that could impact employment such as criminal history, substance use, etc.

Education and Learning Style List the customer’s highest educational credential(s):

List vocational, technical and/or academic (college) training (e.g., HVAC, bachelor’s degree)

Completion Date(s) Skills and/or credentials gained

Would the customer benefit from any other educational experiences to achieve their job(s) of interest?

Based on your observation, how would you describe the customer’s preferred learning style (e.g., lead by example, written instruction)?

Career Exploration and Work Skills Assessment Work and Volunteer History

NA-No past work experience to report Volunteer Paid work School program Internship Apprenticeship Other:

Name of employer or worksite:

Position title: Start Date: End date:

Describe the customer’s transferable skills, likes, and dislikes:

Volunteer Paid work School program Internship Apprenticeship Other:

Name of employer or worksite:

Position title: Start Date: End date:

Describe the customer’s transferable skills, likes, and dislikes:

Volunteer Paid work School program Internship Apprenticeship Other:

Name of employer or worksite:

Position title: Start Date: End date:

Describe the customer’s transferable skills, likes, and dislikes:

Career Exploration https://www.hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/home-community-based-services-hcbs

VR1630 (02/23) Career Planning Assessment Page 4 of 6

List the career exploration activities conducted with the customer (e.g., watched video on being a baker, completed My Next Move interest profile, researched job postings for baker, reviewed labor market for baker, etc.)

List the vocational fields or industries explored with the customer:

Is the customer interested in exploring self-employment options? Yes No

List the types of jobs that interest the customer:

What does the customer like about those types of jobs?

List six job tasks the customer would like to do:

1. 2. 3.

4. 5. 6.

Describe any job task(s) or job interest(s) the customer does not want to pursue:

Customer’s preferred employment conditions (e.g., location, hours, obligations, etc.)?

Work Skills Assessment (For more than 3 settings, attach another VR1630)

NA an Environmental Work Assessment was completed Work Skills Assessment, Work Setting 1 Assessment Activities : Informational interview Worksite tour Customer completed work tasks

Customer observed other employees performing job of interest Other, describe:

Business Name:

Business Location:

Which interests brought the customer to this particular work setting?

Describe information obtained through any informational interviews or observations:

Describe any work tasks the customer performed and the customer’s functional abilities and work tolerance during the assessment:

Describe the customer’s strengths and abilities during the assessment:

Describe the customer’s support needs and challenges during the assessment:

Describe what the customer liked or disliked about the job tasks and work environment:

Work Skills Assessment, Work Setting 2 Assessment Activities : Informational interview Worksite tour Customer completed work tasks

Customer observed other employees performing job of interest Other, describe:

Business Name:

VR1630 (02/23) Career Planning Assessment Page 5 of 6

Work Skills Assessment, Work Setting 3 Assessment Activities : Informational interview Worksite tour Customer completed work tasks

Customer observed other employees performing job of interest Other, describe:

Business Name:

Provider’s Assessment This section allows the provider to list recommendations after the CPA activities are completed.

What do you believe is the best work environment for the customer?

In your opinion, what type of help or services will the customer potentially need to successfully prepare for and find competitive integrated employment?

Describe any short-term and long-term supports the customer will potentially need to maintain competitive integrated employment (e.g., job skills training, natural supports, extended services):

What accommodations might assist the customer with employment (for ideas, see the Job Accommodation Network)?

Additional comments and concerns (if none, type “None”):

Provider Signatures (See VR-SFP 3 on Signatures) Career Planning Assessment Evaluator https://askjan.org/index.cfm https://askjan.org/index.cfm

VR1630 (02/23) Career Planning Assessment Page 6 of 6

By signing below, I certify that:

• The above dates and services are accurate; and

• I personally facilitated the assessment, documented the results in this report, and met all outcomes required for payment listed in the VR-SFP and service authorization.

Typed or Printed name:

Signature:

X Date Signed:

Select all that apply:

UNTWISE Credentialed with ID: VR3490-Waiver Proof Attached Transition Educator Non-traditional

RID/BEI/SLIPI with Number: or proof attached

Director

VRS Use Only Any VR staff member may complete the VRS Use Only section. If any question below is answered no or if the report or supporting documentation is missing or incomplete, return the invoice to the provider with the VR3460. Follow the instructions in VRSM D-208-3: Incomplete or Inaccurate Invoices.

Provider Qualifications Verification Career Planning Assessment Evaluator Credential:

UNTWISE website or attached VR3490 verifies, for the dates of service, the evaluator listed above:

maintained or waived the UNTWISE Supported Employment Credential did not hold a valid UNTWISE Supported Employment Credential

Director Credential:

UNTWISE website or attached VR3490 verifies, for the dates of service, the director listed above:

maintained or waived the UNTWISE Director Credential did not hold a valid UNTWISE Director Credential

UNTWISE Endorsements:

UNTWISE website verifies, for the dates of service, the Supported Employment Specialist listed above maintained the following endorsement:

None Autism Brain Injury Other, specify:

Qualifications Related to Deaf Premium:

Attached documentation verifies, for the dates of service, the Supported Employment Specialist listed above maintained one of the following: Not applicable/no attachment BEI RID SLIPI

Report Verification Verified that the form indicates a minimum of 3 hours of Home and Community Exploration and 6 hours of Career Exploration and Work Skills Assessment Yes No

Verified that the report is accurate and complete, per form instructions and SFP 4 Yes No Verified that the customer received the service Yes No Verified that the service was provided within the dates on the SA Yes No Verified that the appropriate fee(s) was invoiced Yes No VR staff name: Date:

VR1837 (02/23) Report for…