Informed Choice
Click each topic below to read:
- Background
- The Roles of the Individual with Disabilities and the VR Counselor
- The Role of the VR Agency
- Balancing Informed Choice with Other VR Agency Responsibilities
Background
The concept of informed choice in the VR process has been with us for 30 years and is foundational to person-centered service delivery. Nevertheless, informed choice is a concept that many in the VR program have difficulty fully understanding and operationalizing.
The Rehabilitation Act of 1973, as amended, makes it clear in its policy statement that all programs, projects, and activities funded under the Rehabilitation Act, including the VR program under Title I, must be "carried out in a manner consistent with the principles of respect for individual dignity, personal responsibility, self-determination, and pursuit of meaningful careers, based on informed choice, of individuals with disabilities" (section 2(c)(1) of the Rehabilitation Act). The Rehabilitation Act Amendments of 1992 introduced the principle of “informed choice” into the statute and provided individuals with disabilities expanded opportunities for increased involvement in the direction of their VR programming. The Rehabilitation Act Amendments of 1998 strengthened the previous requirements related to informed choice and introduced additional requirements that expanded opportunities for increased participation of individuals with disabilities in developing and implementing their VR programs. This policy is reinforced in section 100(a)(3)(C) of the Rehabilitation Act which states that the State VR program must be carried out in a manner consistent with the following principle: “Individuals who are applicants for such programs or eligible to participate in such programs must be active and full partners in the VR process, making meaningful and informed choices-- (i) during assessments for determining eligibility and VR needs; and (ii) in the selection of employment outcomes for individuals, services needed to achieve the outcomes, entities providing such services, and the methods used to secure such services.”
Specific Regulatory Requirements:
The requirements for informed choice can be found in 34 C.F.R. § 361.52; these provisions reflect statutory language in Section 102(d) of the Rehabilitation Act.
More specifically, 34 C.F.R. § 361.52(a) reiterates the general requirements that the VR agency must provide information and support services needed by applicants for and recipients of VR services in exercising informed choice throughout the rehabilitation process.
Further, 34 C.F.R. § 361.52(b) explains that the VR agency, in consultation with its State Rehabilitation Council, if it has a Council, must develop and implement written policies and procedures that enable an applicant or recipient of services to exercise informed choice throughout the VR process. At a minimum, these policies and procedures must provide for the following:
● Informing each applicant and recipient of services (including students with disabilities and youth with disabilities) about the availability of and opportunities to exercise informed choice throughout the VR process. Such information must be provided using appropriate modes of communication to meet the specific needs of the individual with disabilities. Individuals with cognitive or other disabilities who require assistance in exercising informed choice must also be informed about the availability of support services to assist them in their decision-making process;
● Assisting applicants and recipients of services in exercising informed choice in decisions related to the provision of assessment services;
● Developing and implementing flexible procurement policies and methods that facilitate the provision of VR services and that afford recipients of services meaningful choices among the methods used to procure VR services;
● Assisting eligible individuals or, as appropriate, the individuals' representatives, in acquiring information that enables them to exercise informed choice in the development of their individualized plans for employment (IPE) with respect to the selection of the—
(i) Employment outcome;
(ii) Specific VR services needed to achieve the employment outcome;
(iii) Entity that will provide the services;
(iv) Employment setting and the settings in which the services will be provided; and
(v) Methods available for procuring the services.
Requirements for the types of information that must be provided regarding services and service providers are found in 34 C.F.R. § 361.52(c). In assisting an applicant and eligible individual in exercising informed choice during the assessment process and during the development of the IPE, the VR agency must either provide the individual or the individual's representative or assist the individual or the individual's representative in acquiring, the information necessary to make an informed choice about the specific VR services and the providers of those services that are needed to achieve the individual's employment outcome. This information must include, at a minimum, information relating to the following:
● the cost, accessibility, and duration of potential services;
● Consumer satisfaction with those services to the extent that such information is available;
● the qualifications of potential service providers;
● the types of services offered by the potential providers;
● the degree to which services are provided in integrated settings; and
● the outcomes achieved by individuals working with service providers, to the extent that such information is available.
In providing or assisting the individual or the individual's representative in acquiring the information described above, the VR agency may use, but is not limited to, the following methods or sources of information described in 34 C.F.R. § 361.52(d):
● Lists of services and service providers.
● Periodic consumer satisfaction surveys and reports.
● Referrals to other consumers, consumer groups, or disability advisory councils qualified to discuss the services or service providers.
● Relevant accreditation, certification, or other information relating to the qualifications of service providers.
● Opportunities for individuals to visit or experience various work and service provider settings.
The Roles of the Individual with Disabilities and the VR Counselor
In RSA PD-01-03, dated January 17, 2001, RSA described how the individual with disabilities, the VR counselor, and the VR agency each play an important role in implementing the requirements for informed choice. This information is as relevant today as it was 20 years ago. The VR counselor is the facilitator of this rather complex decision-making process in which the individual with disabilities engages, with the assistance of their representative, if appropriate.
This decision-making process begins with the individual’s engagement in the assessment to determine their eligibility and their VR needs. It continues with the development of their IPE. Options for developing the IPE, including options for the individual to develop all or part of the IPE with or without assistance, can be found in 34 C.F.R. § 361.45(c)(1). Specifically, the individual exercises informed choice in the selection of an employment outcome as well as the selection of the services the individual needs to achieve that outcome. The individual also needs to decide on the settings for such services and the providers they wish to use for such services.
The counselor describes the range of employment outcomes and service options available to the individual during each step of the process, or to the extent possible, the opportunity to create new options that will meet the individual’s specific rehabilitation needs. It is important that the counselor provide the individual with sufficient information about the consequences of various options so that the individual can fairly evaluate these options.
The counselor must then guide the individual in evaluating the information and in making decisions among the various options, or to the extent possible, must provide the individual the opportunity to develop such skills or support and assistance in carrying out these functions. The counselor contributes their knowledge of the VR process, their experience with guiding other individuals with disabilities through the decision-making process, their knowledge of resources available to the individual, and their familiarity with labor market information. The upshot of the informed choice process is to enable the individual to make decisions in ways that reflect their strengths, resources, priorities, concerns, abilities, capabilities, and interests. Finally, the individual must take personal responsibility, to the extent possible, for implementing their chosen options.
Another helpful resource for counselors is RSA’s TAC-98-01, dated November 3, 1997, which describes assisting individuals with cognitive disabilities in exercising their right to informed choice. Again, this TAC is somewhat dated in the terminology used, but the concepts are sound and remain relevant. Specifically, this TAC provides information and strategies for:
• improving the skills needed by the individual to exercise choice;
• providing support and assistance through other individuals;
• simplifying information; and
• using multiple modes of communication and repetition.
The Role of the VR Agency
PD-01-03 goes on to explain that the role of the VR agency is to administer the VR program in a manner that supports the joint efforts of the individual and the VR counselor. Agencies can provide such support in a variety of ways, which include but are not limited to those listed below:
● Consistent with 34 C.F.R. § 361.50(a), the VR agency must develop and maintain written policies covering the nature and scope of each of the VR services specified in §361.48 and the criteria under which each service is provided. The policies must ensure that the provision of services is based on the rehabilitation needs of each individual as identified in that individual's IPE and is consistent with the individual's informed choice. The written policies may not establish any arbitrary limits on the nature and scope of VR services to be provided to the individual to achieve an employment outcome. Exceptions to service policies must be provided in order to meet specific disability-related and other unique needs of the individual.
● In developing and implementing their service policies, VR agencies support informed choice by implementing policies and procedures that provide the maximum opportunity for individuals to exercise informed choice, for the VR counselor to support individuals in that effort, and for the development of employment and service options that meet a wide range of individual needs.
● VR agencies are responsible for facilitating the development of information resources, tools, and support services needed by individuals and counselors to fully implement informed choice. Agencies need to provide the information in accessible formats or modes of communication that individuals can understand.
● The VR agency also has a responsibility to develop or make available a variety of resources to assist individuals in planning, problem-solving, and building decision-making skills. These are skills that have not traditionally been emphasized by agencies.
● Working with State procurement staff and other relevant agencies, the VR agency should seek maximum flexibility in procurement procedures for both the VR program and its participants. The VR agency should assure that its policies and procedures support an individual's ability to exercise informed choice so that the agency's policies and procedures do not result in the pre-selection of employment outcomes, services, and service providers for VR participants. The capacity for resource development can be used to increase the employment and training options that are available for participants and to support the development of service providers willing to negotiate with VR participants about individualized services.
● Providing training about the implementation of informed choice to VR counselors and other service providers who interact with participants helps to assure consistent practices and to disseminate information about innovations.
Balancing Informed Choice with Other VR Agency Responsibilities
The policies developed by the VR agency must also ensure that the availability and scope of informed choice are consistent with all other obligations of the VR agency under 34 C.F.R. part 361 and with the Uniform Guidance in 2 C.F.R. Part 200. This means that informed choice is not unfettered, but rather, it is counterbalanced by other requirements of the statute and regulations. Below are some regulatory requirements that the agency must consider as it works to increase the informed choice provided to individuals with disabilities:
● in 34 C.F.R. § 361.12, the VR agency must assure that it employs methods of administration found necessary by the Department of Education for the proper and efficient administration of the State Plan and for carrying out all functions for which the State is responsible under the plan and 34 C.F.R. part 361. These methods must include procedures to ensure accurate data collection and financial accountability.
● A VR agency must establish and maintain written policies to govern the rates of payment for all purchased VR services (34 C.F.R. § 361.50(c)). The VR agency must maintain effective internal control over rate-setting VR policies to provide reasonable assurance that the agency is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the award.
● The VR agency must promulgate service policies that are consistent with the requirements in 34 C.F.R. § 361.53 on comparable services and benefits and may implement requirements for determining the financial participation of individuals with disabilities in the cost of VR services in accordance with 34 C.F.R. § 361.54. These requirements allow the VR agency to contain costs as long as the policies are implemented fairly and consistently.
● In accordance with the Uniform Guidance in 2 C.F.R. § 200.303, among other things, a non-Federal entity must establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations, and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in Standards for Internal Control in the Federal Government issued by the Comptroller General of the United States and the Internal Control Integrated Framework, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO);
● Furthermore, provisions at 2 C.F.R. § 200.302(b)(7) require that the financial management system of each non-Federal agency must provide for written policies and procedures for determining the allowability of costs in accordance with Federal cost principles and the terms and conditions of the Federal award.