Sec. 247.14. Requirements relating to specific services

(a) Assessment services.

The agency will conduct an assessment for determining eligibility and the priority for services if the agency is operating under an order of selection. The assessment must be conducted in the most integrated setting possible, consistent with the individual's needs and informed choice.

(b) Home modification, adaptive and household equipment.

The agency shall provide home modifications and adaptive and household equipment to meet the functional needs of an individual in the home, if such service is required within the context of the individualized plan for employment. Such services shall be provided only if the following conditions are met:

(1) the individual is in trial work experience or the active caseload;

(2) the services are included in the individualized plan for employment, and are consistent with the employment outcome of the program and any limitations established in writing by the agency for the provision of such services to individuals with such an employment outcome;

(3) the need for the service has been evaluated by a qualified home economist, occupational therapist, registered nurse, counselor or other professional with a background and training in home evaluation;

(4) the owner of a building affected by modifications or installation of equipment has given written permission for such actions;

(5) the individual has given written assurance that the building is intended to be his or her long-term residence;

(6) the modifications or installation of equipment were not contracted or initiated prior to the completion of the individualized plan for employment;

(7) the costs of modifications, adaptive equipment and household equipment do not exceed maximum expenditures for such services established by the agency in writing unless waived by the agency;

(8) the individual meets criteria for financial need; and

(9) the full use of available comparable benefits has been planned prior to the provision of services using agency funds.

(c) Interpreter services for individuals who are deaf.

Such services shall be provided to assure adequate communication between an individual who is deaf and agency staff, or to assure maximum benefit of planned vocational rehabilitation services. They shall be provided only under the following conditions:

(1) the individual is an applicant or is in extended evaluation or the active caseload;

(2) the provision of such service is included in the individualized plan for employment for an individual in the active caseload, or in the written plan, if the individual is in trial work experience;

(3) the full use of comparable services and benefits has been planned prior to the provision of any services using agency funds.

(d) Maintenance.

Maintenance shall be provided to an eligible individual or an individual receiving either trial work or extended evaluation services, when appropriate, to cover additional costs including basic subsistence expenses such as food, shelter and clothing that are in excess of the individual's normal expenses and are necessary because of the individual's participation in a program of vocational rehabilitation.

(1) Types of maintenance.

(i) Major maintenance shall be provided for food, shelter and miscellaneous personal needs for individuals living away from home to compensate for extra expenses incurred while undergoing diagnostic evaluation or participating in a training program. Supplementation for food and shelter provided for an individual participating in a training program while living away from home shall be funded up to a maximum amount established by the agency, provided that such maximum amount shall not exceed the current and actual State University of New York (SUNY) room and board costs. Approval may be granted for a variance from such maximum amount upon a finding by the agency that the cost to the agency resulting from such variance will not be greater than the alternative cost of providing commutation transportation and/or other support services. Major maintenance shall also be provided to individuals living at home only if all the following conditions are met:

(a) the individual has head-of-household status for Federal income tax purposes of either a family or independent unit prior to applying for vocational rehabilitation services or onset of illness or disease;

(b) the individual receives insufficient income from another resource to provide basic support of the family and to provide the individual's shelter; and

(c) the individual is not receiving support from public assistance or supplemental security income as a result of income and/or resources.

(ii) Minor maintenance shall be provided for local transportation, lunch and related miscellaneous expenses for individuals living at home while undergoing diagnostic evaluation, participating in a training program or receiving physical or mental restoration services.

(2) General conditions for payment of maintenance. Maintenance shall be provided only under the following conditions:

(i) the individual is an applicant or is in extended evaluation or the active caseload;

(ii) the individual has incurred additional expenses for basic subsistence items as a result of participating in the vocational rehabilitation program;

(iii) the maintenance is included in the individualized plan for employment and is supportive of other vocational rehabilitation services;

(iv) for maintenance provided to individuals in the active caseload or in extended evaluation, the individual meets the criteria for financial need or is a participant in a program which does not require a determination of financial need.

(e) Medical care for acute conditions.

Medical care shall be provided for acute conditions which arise during a rehabilitation program and which, if not cared for, would complicate or delay the achievement of the employment outcome. Acute medical care shall be provided only under the following conditions:

(1) the individual is in the active caseload or extended evaluation;

(2) the service shall be included in the individualized plan for employment;

(3) the acute medical condition interrupts or threatens to interrupt the progress of the individualized plan for employment;

(4) the service shall be provided by a physician licensed by the state in which such physician practices;

(5) the individual meets the criteria for financial need;

(6) the full use of similar benefits has been planned prior to the provision of such services using agency funds.

(f) Physical and mental restoration.

Physical and mental restoration services shall be provided for the purpose of correcting or substantially modifying a diagnosed physical or mental condition which results in a substantial impediment to employment.

(1) General conditions under which physical and mental restoration shall be provided:

(i) the individual is in extended evaluation or the active caseload;

(ii) the individual's physical and mental impairment is stable or slowly progressive and is likely to require only a limited period of treatment;

(iii) the service is included in the individualized plan for employment;

(iv) the service is provided by professionals who are licensed to provide such services, if the state in which they practice requires such licensure;

(v) the individual meets criteria for financial need or is a participant in a program which does not require a determination of financial need;

(vi) the full use of similar benefits has been planned prior to the provision of such services using agency funds.

(2) Additional conditions relating to hospitalization and related care. The service shall be provided in a facility approved by the New York State Department of Health, or the equivalent approving body of the state in which it operates, and is not provided in long-term care facilities, domiciliary institutions, and non-medically oriented rehabilitation and adjustment training centers.

(3) Additional conditions relating to prosthetic appliances:

(i) the appliance is prescribed by a physician licensed by the state in which such physician practices;

(ii) the service is provided by qualified orthotist and prosthetists.

(g) Post-employment services.

Noncomplex, short-term post-employment services shall be provided to individuals if they are necessary to maintain, regain or advance in employment. Post-employment services shall be provided only under the following conditions:

(1) the individual has achieved an employment outcome through vocational rehabilitation services;

(2) the service is necessary to assist the individual to maintain, regain, or advance in employment;

(3) the individual's rehabilitation needs do not require a comprehensive or complex provision of services. Services needed are limited in scope and are of short duration. If more comprehensive, extensive services are needed, the individual may reapply for services;

(4) the service is related to the objective of the individualized plan for employment and is included in an amendment to it;

(5) the individual meets the criteria for financial need.

(h) Services to other family members.

Services shall be provided to members of an individual's family if such services are necessary to enable the individual to achieve an employment outcome. The services may include any family-oriented services, as well as any of the vocational rehabilitation services provided to individuals. Services to other family members shall be provided only under the following conditions:

(1) the individual is in extended evaluation or the active caseload;

(2) the family member is a relative or guardian of the individual or lives in the same household and has a substantial interest in the well-being of the individual;

(3) the services provided are necessary to enable the individual to achieve an employment outcome;

(4) the service is not readily available through existing community agencies;

(5) the individual meets the criteria for financial need.

(i) Tools, initial stock, equipment, supplies and occupational licenses.

Such items shall be furnished if they are necessary to the individual's successful employment or self-employment following completion of the rehabilitation program. They shall be provided only under the following conditions:

(1) the individual is in the active caseload;

(2) the provision of such items is included in the individualized plan for employment;

(3) the individual meets criteria for financial need.

(j) Training.

(1) Types of training provided. The agency shall provide the following types of training when necessary for the individual to achieve an employment outcome:

(i) personal and vocational adjustment training;

(ii) vocational training;

(iii) vocational training at a rehabilitation facility;

(iv) training at a college, business college or university, provided that the funding for tuition shall not exceed the maximum amount established by the agency, and provided further that such maximum amount shall not exceed the current and actual resident tuition rate for the State University of New York (SUNY) full-time enrollment during an academic year (excluding mini-session, intersession and/or summer session). Funding for tuition for mini-session, intersession, and summer session shall be prorated based on such established maximum. The agency shall waive this maximum, or any prorated amount based on such established maximum, and pay tuition in an amount not to exceed the tuition costs of attending the least expensive public institution of higher education within New York offering an academic program necessary to achieve the student's vocational goal. If there is no such public program in New York State, the actual tuition costs of attending the least expensive non-public institution of higher education may be paid. Tuition and other necessary costs shall be paid only upon a finding that all available means of alternative funding including, but not limited to, grants, scholarships and tuition assistance, have been obtained by the student and subtracted from the tuition, and that payment of the balance of tuition is necessary to achieve the vocational goal of the student. Maintenance provided during such training shall be provided in accordance with subdivision (d) of this section. An individual who attends training out-of-state when necessary training or services are available within New York State, shall bear the full costs of such attendance to the extent they exceed what would have been such costs had the individual attended the least expensive program within New York State;

(v) training at a business school. Maintenance provided during such training shall be provided in accordance with subdivision (d) of this section;

(vi) training at a vocational trade school. Maintenance provided during such training shall be provided in accordance with subdivision (d) of this section;

(vii) training at other educational institutions. Maintenance provided during such training shall be provided in accordance with subdivision (d) of this section;

(viii) on-the-job training;

(ix) correspondence school;

(x) tutoring;

(xi) other training appropriate to the individualized plan for employment.

(2) Conditions for provision of training. Training shall be provided only under the following conditions:

(i) the individual is in trial work experience or the active caseload;

(ii) the service is included in the individualized plan for employment;

(iii) the service is provided at facilities or academic institutions approved or accredited by the state in which they are located;

(iv) the full use of similar benefits has been planned prior to the provision of training with agency funds;

(v) the individual meets the criteria for financial need;

(vi) books and related training materials may be provided, to a maximum combined allowance as established by the agency, provided that such maximum allowance shall not exceed the average cost of books published annually by the State University of New York (SUNY), unless there is documentation of the need to exceed this limit including, but not limited to, written confirmation by appropriate school personnel that each item for which an allowance is made is actually necessary for the individual's participation in a particular course or program.

(k) Vehicle modification and adaptive equipment.

Such services or equipment, including the cost of optional equipment available through the automobile manufacturer, shall be provided if they are necessary because of the individual's disability to enable an individual to use or operate a motor vehicle, and the use or operation of a vehicle is necessary to the rehabilitation of the individual. Vehicle modification and adaptive equipment shall be provided only under the following conditions:

(1) the individual is in trial work experience or the active caseload;

(2) the individual is pursuing or is expected to pursue an employment outcome for which the modification or equipment is necessary, and the provision of such modification or equipment is included in the individualized plan for employment;

(3) the necessity of such services has been justified by a driving evaluator;

(4) the individual and vehicle owner each provides a written statement that a motor vehicle will be available for the individual's use and indicates any conditions or limitations on availability;

(5) the individual meets criteria for financial need;

(6) the individual assumes responsibility for maintenance of the equipment upon installation or delivery.

(l) Special transportation for severely disabled individuals.

Special transportation shall be provided only to those individuals whose disabilities are so severe as to preclude the use of other means of transportation. The unavailability of public transportation shall not constitute a basis for the provision of special transportation.

(m) Other services.

At the option of the agency and subject to approval by the commissioner or an individual designated by the commissioner, other services may be provided to individuals based on their individual needs as components of a planned vocational rehabilitation program, consistent with the financial need requirements contained in section 247.11 of this Part.

(n) Services not provided.

The following items shall not be provided to individuals:

(1) land; or

(2) purchase or construction of buildings.