COVID-19 RELATED SYSTEMIC ACTIVITIES
Between May of 2020 and the end of the reporting period the Vermont Division of Vocational Rehabilitation (DVR) issued a series of “guidance” documents related to DVR services and supports during the Covid-19 pandemic. CAP provided feedback on the initial guidance resulting in changes to the guidance. Thereafter, DVR offered CAP the opportunity to comment on successive guidance before they were finalized. As a result of CAP input, six Covid-19 related policies/procedures/practices were changed.
1)Activity Undertaken: Comment on DVR Covid-19 related guidance related to continuing DVR services and supports where supports do not put DVR employees in danger of Covid-19 infection.
Policy or Practice Changed: DVR required to continue to provide DVR services and supports where supports do not put DVR employees in danger of Covid-19 infection.
Manner in which this change benefitted individuals with disabilities: Individuals with disabilities continued to received VR services and supports throughout the Covid-19 pandemic.
Description: The initial guidance gave the DVR permission to deny support to a consumer when the support the consumer wanted (and was in the Individual Plan for Employment) did not put any DVR employee in danger of becoming infected with Covid-19. As an example, CAP was working with a client who, on her own, had obtained a job at a grocery store, but was being supported by job coaching from DVR. Under the Governor’s then current Executive Order, our client was an essential worker and could continue to work through the pandemic. DVR had agreed to pay for dentures for her in addition to providing job coaching. CAP pointed out that there was no reason for DVR to deny payment for the dentures when no DVR employee would be exposed to risk of Covid-19 infection by our client obtaining her dentures. Similarly, our client’s job coach could check in with her periodically by phone without risk of Covid-19 infection. As a result of CAP’s input, DVR changed the language of the guidance to clarify that DVR would continue to support consumers in ways that did not place DVR employees at risk of Covid-19 infection. As a result of CAP’s comments, DVR consumers continued to receive supports from DVR where those supports did not expose DVR employees to risk of Covid-19 infection.
2) Activity Undertaken: Comment on DVR Covid-10 related guidance related to confidential medical information.
Policy or Practice Changed: DVR not permitted to interrogate consumer regarding their confidential medical information or that of persons with whom they live.
Manner in which this change benefitted individuals with disabilities: Maintained confidential medical information for consumer and those with whom they live.
Description: The initial guidance included a set of factors which would prevent DVR from supporting a consumer to accept a job opportunity during the pandemic. Included in the set of factors were health conditions which might place the consumer in a high-risk category for Covid-19 based on Centers for Disease Control (CDC) guidelines. Also included in the set of factors was whether “the consumer live[s] with other vulnerable adults who could be infected.” CAP objected to the notion that DVR had the right to require consumers to provide DVR with their own personal medical information or to interrogate a consumer about the private medical information of individuals with whom the consumer lived. As a result of CAP’s comments, the factor relating to the medical condition of individuals with whom the consumer lives was withdrawn, and subsequent guidance clarified that VR counselors, if not aware of the consumers underlying health condition through the eligibility process, were encouraged to “review the risk factors with the consumer as part of an informed decision-making process” but not permitted to interrogate consumer on their underlying medical condition. As a result of CAP advocacy the confidential medical information of VR consumers, as well as individuals living with the consumer, was protected.
3) Activity Undertaken: Comment on DVR Covid-19 related guidance related to DVR denial of support for job opportunity that would put consumer at risk due to CDC risk factors.
Policy or Practice Changed: DVR must allow for an exception process to blanket denial of services and supports for job opportunities that might put consumer at risk due to CDC risk factors.
Manner in which this change benefitted individuals with disabilities: DVR will support job opportunities for consumers with CDC identified high risk factors in exceptional circumstances where risk can be mitigated.
Description: The initial guidance permitted DVR to deny support for any job opportunity that would put the consumer at risk due to the CDC risk factors. CAP commented that there should be a process for exceptions to this blanket denial. As a result of CAP’s comments, in subsequent guidance DVR included an exception based on individual circumstances including: the consumer’s ability to work from home; the employment setting allowing the consumer to reliably self-isolate and has strong safeguards in place; the consumer is over 65 but is in very good health.
4) Activity Undertaken: Comment on DVR Covid-19 related guidance related to DVR denial of in person services during Covid-19 pandemic.
Policy or Practice Changed: DVR must allow for an exception process to blanket denial of all in person services and supports.
Manner in which this change benefitted individuals with disabilities: DVR will provide in -person supports in exceptional circumstances.
Description: The initial guidance permitted DVR blanket ability to deny all in-person DVR services. CAP commented that there should be a process for exceptions to this blanket denial of all in-person services. As a result of CAP’s comments, in subsequent “guidance” DVR included an exception for “truly exceptional circumstances” as approved by a DVR Regional Manager.
5) Activity Undertaken: Comment on DVR Covid-19 related guidance related to provision of VR services and supports during Covid-19 pandemic.
Policy or Practice Changed: Clarification of which services and supports DVR must provide to consumers falling into CDC defined high-risk categories who were employed prior to the release of DVR guidance on Covid-19.
Manner in which this change benefitted individuals with disabilities: DVR will continue to support the employment of consumers falling into one of the high-risk categories if they were employed prior to the release of the initial guidance
Description: The initial guidance did not distinguish, for purposes of the provision of DVR supports to consumers falling into high-risk categories, between consumers who were employed prior to the release of the initial guidance and consumers seeking employment at the time of the release of the initial guidance. CAP commented that different standards should be applied in order to support employed consumers to maintain their jobs. As a result of CAP’s comments, subsequent guidance stated that DVR would continue to support the employment of consumers falling into one of the high-risk categories if they were employed prior to the release of the initial guidance.
6) Activity Undertaken: Comment on need to provide notice and opportunity to appeal any delay or denial of VR services related to circumstances created by Covid-19.
Policy or Practice Changed: Notice and information on consumer appeal rights will be provided for any delay or denial of VR services related to circumstances created by Covid-19.
Manner in which this change benefitted individuals with disabilities: VR consumers will have their due process rights protected.
Description: CAP commented that any decision to deny or delay DVR support to a consumer due to they’re being in a high-risk category for Covid-19, must be accompanied by written notice of the basis of the decision and advising the consumer of their right to appeal the decision and directing them to the CAP for help with understanding their rights or assistance with an appeal. As a result of CAP advocacy DVR drafted a “Notice” letter and requested CAP input.
NON COVID -19 RELATED SYSTEMIC ACTIVITIES
7) Activity Undertaken: Change to Policy and Procedures Manual
Policy or Practice Changed: Clarification that VR consumers who are eligible for SSI or SSDI cannot be required to contribute to the cost of VR services or supports.
Manner in which this change benefitted individuals with disabilities: People with disabilities will not be required to contribute to the cost of VR services or supports.
Description: As part of its work with the Policy and Procedure subcommittee of the State Vocational Rehabilitation Council, PADD advocated for changes in the Policy and Procedures Manual to clarify that, consistent with Federal regulations, VR consumers who are eligible for SSI or SSDI cannot be asked to contribute to the cost of VR services or supports. Based on its experience, CAP felt that not all VR counselor were aware of this and that an affirmative statement in the Policy and Procedures Manual was needed. As a result of CAP advocacy, the committee voted to create a new stand-alone chapter in the Policy and Procedures Manual to clarify that VR consumers who are eligible for SSI or SSDI may not be required to contribute to the cost of VR services or supports. CAP will be involved in drafting the new chapter.
In addition to these specific policy changes, CAP systemic advocacy does not always directly impact a policy but does inform the thinking and decisions of policy makers and thus affect the lives of people with disabilities. CAP engaged in non-specific systemic advocacy in 2020 through the following activities:
CAP staff sits on the SRC-VR and chairs the Policy & Procedures subcommittee. CAP participated in meetings of the SRC-VR Performance Review and Advocacy and Outreach and Education Committees. Through participation in these committees CAP has engaged in the following systemic advocacy activities in FY2020:
• Participated in SRC annual retreat provided input regarding VR needs assessment data and setting priorities for FY 21.
• Attended and provided input at full SRC meetings, including
o Possible uses for $5.1 million reallotment grant
o Findings of needs assessment
• Chaired the SRC Policies and Procedures Committee. Provided input and drafting assistance related to VR policies specifically:
o Revision and approval of audiology and hearing aids policy to reflect best practice and consistent VR procedures, and
o Revision and approval of policy related to post-secondary education and training to bring VT VR policy into compliance with WIOA’s focus on multiple career pathways and higher wage employment, including access to shorter term credential attainment (apprenticeships, on-the-job-training, entry-level credentials, marketable skill acquisition) opportunities with lower time commitment and debt acquisition for consumers.
• Participated in meetings of SRC Performance Review conducting extensive review of feedback from triennial VR needs assessment with comment regarding data reflecting unmet needs of consumers with mental health disabilities.
o Participated in Advocacy Outreach and Education (AOE) Committees, including discussion of need for legislation to require coverage for hearing aids by all insurance providers.
o Supported SRC AOE Committee advocacy to successfully obtain blanket permission for VR to fill counselor vacancies as they occur and unfreeze funding for positions previously denied
o Reviewed first Youth Consumer Satisfaction Survey since WIOA enactment (Only 2nd state in nation to do so).
• Participated in SRC Steering Committee and provided CAP input leading to improvements in the membership process, including
o Adding membership as a standing agenda item for the committee
o Changing the membership application process to include review by the committee (personally identifiable information redacted to ensure privacy)
o Ongoing monitoring for diversity, geographic location, disability category, etc. (current membership 58% people with disabilities)
o Creating videos for new member orientation regarding work of committees
• Participated in VR Implementation Team (I-Team) meeting providing input on
o next steps in VR process following initial assessments of career interests and consumer strengths /barriers to employment.
o VR exploration of better outreach to people with disabilities, including changes in marketing and rebranding of agency leading to increased participation in services
• Initiated review of VT Center for Independent Living (CILs) policies and procedures and contacted New England CAPs to solicit information about relationship between CAPs and CILs in respective states.
CAP staff also sits on the State Rehabilitation Council for the Blind and Visually Impaired (SRC-BVI). The SRC-BVI is charged with reviewing and advising DBVI regarding the performance of their responsibilities relating to the effectiveness of services provided, and functions performed that may affect the ability of individuals with disabilities in achieving employment goals and priorities. In partnership with the Division for the Blind and Visually Impaired, the Council helps to develop and review State goals and priorities and evaluate the effectiveness of the VR program. CAP serves on the Policy and Procedures subcommittee of the SRC-BVI and in this capacity advocates for policies that result in better services for Vermonters with disabilities.
CAP advocates have regularly scheduled meetings with the Director of the Division of Vocational Rehabilitation and two of her management staff. The purpose of these meetings is to discuss systemic concerns and issues and maintain an open line of communication between the CAP and VR.
CAP staff serves as a governor appointed member of the Department of Disabilities, Aging and Independent Living (DAIL) Advisory Board. The Division of Vocational Rehabilitation is a Department within DAIL. The DAIL Advisory Board meets once a month and provides feedback on DAIL programs including VR.
CAP staff also serves as a governor appointed member of the Developmental Disabilities Services Division Advisory Board. This board meets monthly and provides input and feedback to the Director of the Developmental Services Division of DAIL, which, among other programs, funds and oversees supported employment for individuals with intellectual and developmental disabilities in Vermont.