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An Assessment Instrument for Families: Evaluating
Community-Based Residential Programs for
Individuals with Deaf-Blindness
Developed by:
Helen Keller National Center -Technical Assistance Center
Hilton/Perkins Project
Members of the National Parent Network Advisory Committee
September, 1991
In a 2007 survey of 146 Parents of transitioning or transitioned deafblind youth reported the following:
 90% identified physical and emotional safety as extremely important
 70% financial security
 64% continued lifelong learning
 62% place to live
 60% developing relationships
National Family Association Deaf-Blind (NFADB)
unpublished results 2007
PHYSICAL ATTRIBUTES OF HOME
GENERAL APPEARANCE
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Maintenance of the house
Upkeep of grounds
Condition of furniture
Attractiveness of décor
Residents’ preferences reflected in decor
PHYSICAL ATTRIBUTES OF HOME
ATMOSPHERE
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Homelike atmosphere
Morale of staff
Sufficient space for residents and staff at peak times of day
Residents' preferences displayed in bedroom and living areas
Space for recreation both indoors and outside
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PHYSICAL ATTRIBUTES OF HOME
ENVIRONMENTAL ADAPTATIONS
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Safe environment; obstacle-free environment
Wheelchair accessibility
Physical layout of house
Adequate lighting; use of colors and contrast
Signaling systems
Use of adaptive technology
Available funding for adaptations
PHYSICAL ATTRIBUTES OF HOME
LOCATION
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Atmosphere of neighborhood; traffic patterns
Available nearby resources; e.g., stores, parks, restaurants, churches, temples
Community recreation programs
Involvement of neighbors
Transportation capacity of home
RESOURCES FOR PROMOTING CAPABILITIES
STAFF
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Number of staff working on weekdays/weekends
Ratio of staff to residents
Ratio needed by your son or daughter
Turn-over rate of staff
Average length of time current staff has been working in program
Type of certification, if any, needed by staff
Level of staff experience relative to your son/daughter's needs
Frequency of training offered to staff
Type of training offered to staff relative to your son/daughter's needs
Training resources available to agency relative to your
son/daughter's needs
RESOURCES FOR PROMOTING CAPABILITIES
PLANNING PROCESS
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Planning process is person-centered
Level of client involvement
Level of parent involvement
Access to on-going decision making process
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RESOURCES FOR PROMOTING CAPABILITIES
PROGRAM
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Evidence of flexibility and creativity in offering diverse activities
Examples of recreation/leisure activities from the past several months
Comparison of recreation/leisure activities offered with your child's preferences
and abilities
Access to orientation and mobility instruction
Integration of orientation and mobility in most daily activities
Residents' participation in the daily functions of the home e.g., cooking, cleaning,
gardening, shopping
Choice-making opportunities are integrated in routines and activities
Strategies used in working with behavioral challenges
Behavioral programs reflect a sensitivity and respect for residents' preferences
and right to make choices
RESOURCES FOR PROMOTING CAPABILITIES
COMMUNICATION STRATEGIES
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How "personal connections" are established
Staff rapport with residents
Examples of clients making choices and demonstrating preferences
Evidence of staff awareness of the different communication styles of each
resident
Evidence of the staff using a variety of methods of communication; e.g., sign,
pictures, objects, gestures
Evidence of clients using a variety of methods of communication; e.g., sign,
picture books, objects, gestures; calendar box
Willingness of staff to wait for a resident to communicate even if it takes a while
Integration of communication in all activities
RESOURCES FOR PROMOTING CAPABILITIES
EVALUATION PROCEDURES
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How the program is evaluated
Frequency of evaluations
Who evaluates the program
Existence of a quality assurance process
Availability of evaluation results to parents
Follow-through on recommendations
Who funds the program
How donations are made; how they are spent
What, if any, were the conditions for this funding
Written contract for the program
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RESOURCES FOR PROMOTING CAPABILITIES
MEDICAL/SUPPORT SERVICES
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Frequency and extent of medical services required by your son/daughter
Availability and accessibility of:
o medical services needed
o adequate dental care
o physical therapy
o psychological counseling
Staff capability of providing follow-up; e.g., therapy; seizure monitoring; extensive
medications
How medications are monitored
Agency policy on infection control
Transportation to medical appointments
PHILOSOPHY
POLICIES
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Agency's mission statement, if written
House manuals, if available
Agency's statements on human rights, client dignity
Agency's written goals for integration and ongoing
Education Agency's adherence to licensing codes
Agency's policy of selecting residents
Agency's policy on termination of placements
PHILOSOPHY
VALUES
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How agency values match with your values/hopes/dreams
Examples of values:
o providing opportunities to learn and grow
o treating people with respect and dignity,
o right to privacy,
o right to make choices,
o respecting religious beliefs,
o having fun; having friends,
o providing a safe clean environment,
o Individual opportunities for community interaction
Examples of other values:
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PHILOSOPHY
REALIZATION OF VALUES
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Examples of choices that residents' make
Listing of new things learned by resident's
Evidence that residents' feelings are taken seriously
Diversity of activities offered
Age-appropriateness of activities
Examples of how individual preferences are respected
Examples of how staff promotes self-esteem
Open door policy to visitors and guests
Respect for individual sexual needs
Promotion of social relationships with: housemates; staff; neighbors;
acquaintances
Instances of resident's laughing; smiling or showing pleasure
PHILOSOPHY
RESIDENTS
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What the other resident's in the home are like
Number of resident's living in the home
Housemate's compatibility in interests and capabilities
Possibilities of peer support
Residents' feelings toward their home
Residents' access to their own money
PHILOSOPHY
FAMILY/GUARDIAN INVOLVEMENT
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Level of parental involvement
How parents are invited/encouraged to participate
Communication mechanisms between staff and parents and opportunities for
expressing concerns, support, questions, etc.
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UNITED STATES DEPARTMENT OF EDUCATION
OFFICE OF SPECIAL EDUCATION AND
REHABILITATIVE SERVICES
REHABILITATION SERVICES ADMINISTRATION
WASHINGTON, DC 20202
TECHNICAL ASSISTANCE CIRCULAR
RSA-TAC-02-01
DATE: February 11, 2002
TO: STATE VOCATIONAL REHABILITATION AGENCIES (GENERAL)
STATE VOCATIONAL REHABILITATION AGENCIES (BLIND)
STATE REHABILITATION COUNCILS
CLIENT ASSISTANCE PROGRAMS
REGIONAL REHABILITATION CONTINUING EDUCATION PROGRAMS
AMERICAN INDIAN VOCATIONAL REHABILITATION SERVICES PROJECTS
RSA SENIOR MANAGEMENT TEAM
SUBJECT: ASSESSMENTS OF INDIVIDUALS WITH SIGNIFICANT
DISABILITIES UNDER THE STATE VOCATIONAL
REHABILITATION SERVICES PROGRAM
BACKGROUND:
This Technical Assistance Circular (TAC) clarifies the process that must be followed in
assessing whether individuals with disabilities, particularly those with significant or the
most significant disabilities, are eligible under the State Vocational Rehabilitation
Services Program (VR program) which is authorized by Title I of the Rehabilitation Act
of 1973, as amended (Act). This TAC follows the recent revision to the scope of
available employment outcomes under the VR program to include only outcomes in
integrated settings.
On January 22, 2001, amendments to the definition of the term “employment outcome”
in regulations for the VR program were published in the Federal Register (66 FR 7249).
These final regulations amended the definition of “employment outcome” in 34 CFR
361.5(b)(16) to read:
“(16) Employment outcome means, with respect to an individual, entering or retaining
full-time or, if appropriate, part-time competitive employment, as defined in Sec.
361.5(b)(11), in the integrated labor market, supported employment, or any other type of
employment in an integrated setting, including self-employment, telecommuting, or
business ownership, that is consistent with an individual's strengths, resources,
priorities, concerns, abilities, capabilities, interests, and informed choice. (Emphasis
added).
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The term “integrated setting” -- defined in 34 CFR §361.5(33)(ii) as a "setting typically
found in the community in which individuals with disabilities interact with non-disabled
individuals to the same extent that non-disabled individuals in comparable positions
interact with other persons -- was unchanged by the regulatory amendments.
The revised regulations included in the January 22, 2001 Notice became effective for all
designated State VR agencies on October 1, 2001 (as explained in a subsequent
Federal Register Notice, 66 FR 8870). The primary purpose of the change to the
definition of “employment outcome,” and the conforming changes to other regulatory
provisions in 34 CFR 361, was to ensure that persons with disabilities participating in
the VR program, particularly those with significant disabilities, are assisted by State
Vocational Rehabilitation (VR) agencies in pursuing employment in integrated settings
in the community. In that regard, the Rehabilitation Services Administration (RSA)
determined that, consistent with the Act, narrowing the scope of available employment
outcomes under the VR program to competitive employment, supported employment
and other forms of integrated employment was necessary to both provide individuals
with significant disabilities employment opportunities in settings comparable to nondisabled individuals and to ensure that individuals with significant disabilities are not
routinely placed in extended employment (i.e., sheltered work settings) based on the
view that they are only capable of sheltered work as opposed to integrated employment
in the community.
This TAC is intended to address a key issue related to the promulgation of the revised
regulations. Specifically, we wish to emphasize the process that State VR agencies
must follow in assessing whether an individual with a disability, including an individual
with a significant disability (defined in section 7(21)(A) of the Act and 34 CFR
361.5(b)(31)) and an individual with a most significant disability (defined in section
7(21)(E) of the Act and 34 CFR 361.5(b)(30)), is eligible under the VR program. This
Circular is particularly necessary since all participants in the VR program are now
required to pursue employment in an integrated setting in order to receive services
under the VR program.
We note that the January 22, 2001 Federal Register Notice also includes a number of
other changes to the VR program regulations that are elated to the revised definition of
the term “employment outcome,” and also includes extensive guidance material
concerning the justification and consequences of the revised definition. In particular,
the revised regulations require VR agencies to refer to local extended employment
providers (e.g., community rehabilitation programs) individuals with disabilities who
make an informed choice to pursue extended employment after the State unit has
informed the individual of the nature of the VR program, the individual’s integrated
employment options, and other important information specified in the regulations (see
34 CFR 361.37(b) of the revised regulations). The guidance in the Appendix also
makes clear that extended employment remains a viable, interim option for purposes of
preparing participants in the VR program for employment in integrated settings and a
long-term employment option through sources other than the VR program for those
individuals who prefer to work in extended employment facilities. Please refer to pages
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7252 - 7253 of the January 22, 2001 Federal Register Notice for additional regulatory
changes and to the Questions and Answers on Pages 7254 and the Analysis of
Comments and Changes on Pages 7254 - 7258 of the notice for additional guidance
material.
Below, however, is a description of the process that State VR agencies must follow in
assessing whether individuals with disabilities, including individuals with significant and
the most significant disabilities, are eligible under the VR program. By clarifying the
eligibility process, we intend to ensure that eligibility assessments for persons with
significant and the most significant disabilities are properly conducted and are not
prematurely discontinued or otherwise conducted in a manner that is inconsistent with
VR program requirements.
DISCUSSION:
The eligibility criteria for the VR program are specified in section 102(a) of the Act and
34 CFR 361.42 of the program regulations. According to these requirements, an
individual is eligible to receive VR services if he or she is “an individual with a disability,”
meaning that the individual has a physical or mental impairment that results in an
impediment to employment and can benefit in terms of an employment outcome from
VR services. The individual also must require VR services in order to prepare for,
secure, retain, or regain employment. (See Sections 7(20)(A) and 102(a)(1) of the Act
and 34 CFR 361.5(b)(28) and 361.42(a)(1)).
In applying the eligibility criteria to individuals with disabilities seeking VR services,
particularly individuals with significant and the most significant disabilities, it is critical to
note that both the Act and regulations specify that any individual seeking VR services
is “presumed” able to benefit in terms of an employment outcome from VR services
unless the State VR agency can demonstrate by clear and convincing evidence that the
individual is incapable of benefiting in terms of an employment outcome under the VR
program due to the severity of the individual's disability. (See section 102(a)(2)(A) of
the Act and 34 CFR 361.42(a)(2)). For guidance purposes, “clear and convincing
evidence” is described in a Note following 34 CFR 361.42 as, in part, the highest
standard in our civil system of law whereby State agencies must have a high degree of
certainty before concluding that an individual is incapable of benefiting from services in
terms of an employment outcome. The term “clear,” as stated in the Note, means
unequivocal.
Given that, as of October 1, 2001, employment outcomes under the VR program are
limited to employment in integrated settings, the presumption that all individuals are
able to benefit in terms of an “employment outcome” from VR services means that all
individuals, including those with significant or the most significant disabilities, are
presumed capable of working in an integrated setting provided that they are furnished
necessary VR services. The expectation established by both the Act and regulations
through, for example, the priority the Act affords individuals with significant disabilities
under the order of selection requirements (see 101(a)(5) of the Act and 34 CFR 361.36)
and through the presumption of benefit described above -- is that individuals with
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significant disabilities are capable of working in integrated settings in the community and
that VR agencies should assist those individuals in that pursuit. Although some
individuals seeking VR services may, in light of the severity of their disability, be
considered by State VR agencies unable to perform work in an integrated setting, the
agency must establish clear and convincing evidence to that effect before determining
that the individual is ineligible for VR services.
The Act and regulations also specify steps that must be taken by State VR agencies
before it can establish “clear and convincing evidence'' demonstrating that an individual
is incapable of working in an integrated setting. Section 102(a)(1)(B) of the Act states
that in order to demonstrate by clear and convincing evidence that an individual cannot
benefit in terms of an employment outcome from VR services due to the severity of the
individual’s disability, the State VR agency shall:
“(B) Explore the individual’s abilities, capabilities, and capacity to perform
in realistic work situations, through the use of trial work experiences, with
appropriate supports. . . .”
Based on this authority, the regulations at 34 CFR§361.42(e) require the agency to
develop a written plan for assessing the individual’s progress during trial work
experiences and specify that:
The individual's abilities, capabilities, and capacity to perform in realistic work situations
must be periodically assessed;
Trial work experiences must be conducted in realistic work settings;
Necessary and appropriate supports, including assistive technology devices and
services and personal assistance services, must be provided to accommodate the
rehabilitation needs of the individual during the trial work experiences; and Trial work
experiences must be of sufficient variety and over a sufficient period of time to result in
sufficient evidence to conclude either that: (1) the individual can benefit in terms of an
employment outcome from VR services (i.e., is capable of working in an integrated
setting) in which case the individual is eligible for VR services, or (2) there is “clear and
convincing evidence” to the contrary (i.e., clear and convincing evidence that the
individual cannot work in an integrated setting due to the severity of the individual’s
disability) in which case the individual is ineligible for VR services (and must be referred
to a local extended employment provider in accordance with 34 CFR 361.37 as revised
by the regulations published in the January 22, 2001 Federal Register Notice; the
procedures for making ineligibility determinations in 34 CFR 361.43 must also be
followed). (See Sections 7(2)(D) and 102(a)(2)(B) of the Act and 34 CFR§361.42(e)).
Notably, the regulations also describe the State VR agency’s obligations in instances in
which an individual cannot take advantage of trial work experiences or if options for trial
work experiences have been exhausted without the agency being able to determine
whether the individual is eligible for VR services.
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Please refer to the provisions of 34 CFR §361.42(f) for information concerning the
required use of extended evaluation under such circumstances.
We’ve described this step-by-step approach to the eligibility process in order to highlight
the steps that must be followed in determining whether an individual with disability,
particularly an individual with a significant disability and an individual with a most
significant disability, is capable of integrated employment and, correspondingly, eligible
under the VR program. We caution State VR agencies that they must ensure that the
full scope of the eligibility requirements discussed above are satisfied rather than
determining an individual ineligible for VR services based on a belief or limited
information indicating that the individual is too severely disabled to perform work in an
integrated setting. If a State VR agency conducts only a limited assessment, meaning
that it has insufficient information to demonstrate conclusively that the individual does
not have the ability or capacity to work in an integrated setting, then an individualized
assessment must continue until such time that clear and convincing evidence is
established, or the individual is found to be capable of working in an integrated setting.
Because an individualized assessment, including the trial work experiences component,
must be carried out until either of these results is reached, agencies also must not
impose arbitrary time limits on eligibility assessments. As we stated in the Appendix to
the January 22, 2001 Federal Register Notice, in the absence of clear and convincing
evidence following a trial work assessment of the individual's abilities (or, as
appropriate, an extended evaluation under 34 CFR 361.42(f)), VR agencies must
consider each individual, including those with the most significant disabilities, capable of
achieving integrated employment.
CONCLUSION:
The Act and regulations prohibit determining any person with a disability, including any
individual with a significant or a most significant disability, ineligible under the VR
program based on an assumption, belief, or limited information that the individual is
incapable of working in an integrated setting. When there is doubt regarding an
individual's ability to benefit from VR services in terms of employment in an integrated
job setting due to the severity of the individual's disability, the Act and the regulations
require the State VR agency to conduct an individualized assessment that includes the
provision of trial work experiences in realistic work settings until such time that the
individual is found capable of working in an integrated setting (when provided
appropriate VR services) or there is clear and convincing evidence that the individual
cannot perform such work.
EFFECTIVE DATE: Issue Date
EXPIRATION DATE: Until Retired
INQUIRIES: RSA Regional Commissioners
Joanne M. Wilson, Commissioner
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Notes:
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