LAC 67:VII.115. Financial

A. Application of a Financial Needs Test 1. A financial needs test shall be applied to determine an individual’s ability to contribute to the cost of vocational rehabilitation services, except where prohibited by federal law or regulation. The administration of the financial needs test may be activated or suspended in response to fiscal conditions, resource availability, or other factors affecting the delivery of vocational rehabilitation services. B. Determination of Application 1. The decision to apply or suspend the financial needs test shall be made through an administrative review process based on an evaluation of current funding, service demand, and other relevant fiscal considerations. 2. Any modification to the financial needs test shall be documented and issued through an official directive, specifying the effective date and scope of the change. C. Effect of Suspension 1. When suspended, individuals shall not be required to undergo a financial needs assessment, and services subject to the test shall be provided without financial participation. 2. When reinstated, the financial needs test shall be applied in accordance with the provisions outlined in this rule. D. Notice and Implementation 1. Any change in the application of the financial needs test shall be publicly posted and communicated to all relevant stakeholders, including applicants, service providers, and agency personnel. 2. The agency shall ensure compliance with all federal and state regulations when modifying the application of the financial needs test. 3. The financial needs test will include a review of income, disability-related expenses and comparable services and benefits, the financial need of eligible individuals; and individuals who are in trial work periods for purposes of determining the extent of the individual’s participation in the costs of certain vocational rehabilitation services. 4. A financial needs test or requiring financial participation as a condition for providing VR services to an individual who has been determined eligible for Social Security benefits under Titles II or XVI of the Social Security Act (i.e., recipients of Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI)) is prohibited. E. Comparable Services and Similar Benefits 1. Comparable services and similar benefits means services and benefits including accommodations and auxiliary aids and services, that are provided or paid for, in whole or in part, by other Federal, State, or local public agencies, by health insurance, or by employee benefits; available to the individual at the time needed; and commensurate to the services that the individual would otherwise receive from LRS. LRS must use comparable services or benefits to meet, in whole or part, the costs of the vocational rehabilitation services. F. Determination of Availability 1. Prior to providing any vocational rehabilitation service to an eligible individual, except those services specified below as exempt services, LRS will determine whether comparable services and benefits are available under any other program (other than a program carried out under Title IV, Rehabilitation Act Amendments of 2014) unless such a determination would interrupt or delay: a. the progress of the individual toward achieving the employment outcome identified in the Individualized plan for employment of the individual; b. an immediate job placement; or c. the provision of such service to any individual at extreme medical risk based upon medical evidence provided by an appropriate qualified medical professional. G. Awards and Scholarships 1. For purposes of the determination of availability of comparable services and similar benefits, scholarships or awards based on merit or student loans do not count as grant assistance, for purposes of searching for comparable benefits, under the VR program. H. Exempt Services 1. The following vocational rehabilitation services can be provided without making a determination of the availability of comparable services and benefits: a. services provided through LRS's information and referral system; b. assessment for determining eligibility and vocational rehabilitation needs, including if appropriate, assessment by personnel skilled in rehabilitation technology; c. counseling and guidance, including information and support services to assist an individual in exercising informed choice; d. referral and other services needed to secure necessary services from other agencies, if such services are not available from LRS; e. job-related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services; f. rehabilitation technology, including telecommunications, sensory, and other technological aids and devices; g. post-employment services consisting of the services listed in this Section. I. Participation in the cost of Vocational Rehabilitation Services based upon need 1. A financial needs test is not applied and no financial participation is required as a condition for furnishing the following vocational rehabilitation services: a. assessment for determining eligibility and priority for services, except those non-assessment services that are provided during an evaluation to explore the individual's abilities, capabilities, and capacity to perform in work situations (trial work periods); b. assessment for determining vocational rehabilitation needs; c. counseling, guidance, including information and support services to assist an individual in exercising informed choice; d. referral and other services necessary to assist applicants and eligible individuals to secure needed services from other agencies and to advise those individuals about client assistance programs; e. job-related services, including job search and placement assistance, job retention services, follow-up services, and follow-along services; f. rehabilitation technology assessments; g. supported employment; h. on-the-job training; i. assistive technology devices and services (except hearing aids); j. orthotic and prosthetic devices; k. personal assistance services provided simultaneously with any of the above-listed vocational rehabilitation services; (Examples include attendant, reader, scribe, interpreter, ASL, and notetaker services.) l. disability related augmentative skills training services; m. post-employment services consisting of the services listed in this section. 2. A financial need test, when applicable, will be applied to determine the ability of the individual to financially contribute to the cost of the following vocational rehabilitation services: a. physical restoration and/or mental restoration; (except orthotic and prosthetic devices); b. hearing aids; c. maintenance; d. transportation; e. books and supplies; f. occupational tools and equipment; g. cost services to other family members; h. occupational licenses; i. discretionary training fees such as those that are not included in tuition; j. vocational and other training services, such as college/university, vocational and proprietary school training; k. other goods and services, not specifically identified in Subsection I.1 above; l. post-employment services consisting of the services listed above. 3. LRS shall determine an individual’s financial need for vocational rehabilitation services as applicable, as listed in Paragraph 2 above, based on the individual’s income, disability related expenses, and a multiple of 250 - 500 percent of the current U.S. Department of Health and Human Services’ poverty guidelines. 4. When it is determined by a counselor and an eligible applicant that self-employment, through establishment of a small business enterprise, is the best option for the applicant/participant, the applicant/participant must provide a minimum cash capital contribution of 20 percent of the total transaction. 5. Individuals who do not provide LRS with necessary financial information to perform the budget analysis will be eligible only for those vocational rehabilitation services that are not conditioned upon an analysis to determine the extent of the individual's participation in the costs of such services. 6. Individuals who have defaulted on a student loan must make good faith efforts with the lender to clear the default or to defer payment before LRS will participate in the cost of the participant's post-secondary training and supports. 7. Simultaneously with the comprehensive assessment, at the annual review of the IPE, and at any time there is a change in the financial situation of either the participant or the family, the counselor will perform a financial needs test, as applicable, for each participant requiring vocational rehabilitation services that requires a financial needs test. The amount of participation in the cost of their vocational rehabilitation program will be based upon the most recent financial needs test at the time the relevant IPE or amendment is developed. J. Additional Requirements 1. State and Departmental Purchasing Procedures. All applicable state, departmental and agency purchasing policies and procedures must be followed. 2. LRS does not purchase vehicles, real estate, or any equipment or service that requires ongoing costs (e.g. property taxes). An exception would include identification of a one-time payment or specified period of time with expectation that the participant would be able to assume further ongoing costs. NOTE: Vehicles include all motor vehicles, all-terrain vehicles, and utility task vehicles. 3. Fee Schedule. Services and rates of payment must be authorized in accordance with LRS's Medical Fee Schedule and LRS's Technical Assistance and Guidance Manual, which lists current established rates and approved service providers. 4. Approval of Service Providers a. Any service provider approved by the agency must agree not to make any additional charge to or accept any additional payment from the participant or participant's family for services authorized by the agency. b. Relatives of vocational rehabilitation participants will not be approved as a paid service provider unless such individuals are professionally and occupationally engaged in the delivery of such services by offering their services to the general public on a regular and consistent basis. 5. Prior Written Authorization and Encumbrance a. Either before or at the same time as the initiation or delivery of goods or services, the agency must be in possession of the proper authorizing document. The only exception is in an emergency situation. b. If oral authorization of approved services is made in an emergency situation, there must be prompt documentation, and the authorization must be confirmed in writing and forwarded to the provider of the services.