Ch. 5: Brain Injury Extended Support Program

SECTION 1. PURPOSE

The purpose of this program is to provide ongoing extended supports to individuals with brain injuries who are VR consumers with the most significant disabilities once training has been completed. The program provides financial assistance to providers of ongoing support and/or employers to help defray the additional cost incurred providing job coaching, training and supervision on a supported work site.

SECTION 2. DEFINITIONS

Supported Employment means competitive integrated employment, including customized employment, or employment in an integrated work setting in which an individual with a most significant disability, including a youth with a most significant disability, is working on a short-term basis toward competitive integrated employment that is individualized, and customized, consistent with the unique strengths, abilities, interests, and informed choice of the individual, including with ongoing support services for individuals with the most significant disabilities –

For whom competitive integrated employment has not historically occurred, or for whom competitive integrated employment has been interrupted or intermittent as a result of a significant disability; and

Who, because of the nature and severity of their disabilities, need intensive supported employment services and extended services after the transition from support provided by the designated State unit, in order to perform this work

ployment has not historically occurred, or for whom competitive integrated employment has been interrupted or intermittent as a result of a significant disability; and

Who, because of the nature and severity of their disabilities, need intensive supported employment services and extended services after the transition from support provided by the designated State unit, in order to perform this work.

Extended Support Services means ongoing support services and other appropriate services, needed to support and maintain an individual with a most significant disability in supported employment, that –

(A) are provided singly or in combination and are organized and made available in such a way as to assist an eligible individual in maintaining supported employment;

(B) are based on a determination of the needs of an eligible individual, as specified in an individualized plan for employment; and

(C) are provided by a State agency, a nonprofit private organization, employer, or any other appropriate resource, after an individual has made the transition from support provided by the designated State unit.

3. Brain Injury: "Brain Injury" means an insult to the brain resulting directly or indirectly from trauma, anoxia, vascular lesions or infection, which:

A. is not of a degenerative or congenital nature;

B. can produce a diminished or altered state of consciousness resulting in impairment of cognitive abilities or physical functioning;

C. can result in the disturbance of behavioral or emotional functioning;

D. can be either temporary or permanent; and

E. can cause partial or total functional disability or psychological maladjustment.

SECTION 3. BRAIN INJURY EXTENDED SUPPORT APPEALS PROCESS

An applicant for or recipient of Extended Support services who is dissatisfied with any determination made by the Bureau of Rehabilitation Services concerning the furnishing or denial of services may request a timely review of the determination

ermanent; and

E. can cause partial or total functional disability or psychological maladjustment.

SECTION 3. BRAIN INJURY EXTENDED SUPPORT APPEALS PROCESS

An applicant for or recipient of Extended Support services who is dissatisfied with any determination made by the Bureau of Rehabilitation Services concerning the furnishing or denial of services may request a timely review of the determination. The Bureau shall make reasonable accessibility accommodations for the individual with disabilities during the appeals process. Whenever possible, the Bureau will attempt to resolve conflicts through Informal Review or through Mediation. An individual may request a Due Process Hearing immediately without having to go through other appeal steps.

1. Informal Review

Whenever possible, Maine DVR or DBVI will attempt to resolve conflicts informally, prior to Mediation or a Due Process Hearing. An individual may request a meeting with the counselor, the appropriate supervisor, and/or a Client Assistance Program representative, if desired, to explore options for resolving any conflicts. An individual may request Mediation or a Due Process Hearing immediately, without having to go through the informal process.

2. Continuation of Services Pending Completion of the Hearing

Pending a final determination of an appeal hearing, the DVR or DBVI may not suspend, reduce, or terminate services being provided under an Individualized Plan of Employment (IPE), unless the services were obtained through misrepresentation, fraud or collusion of the individual, or unless the individual, or individual’s authorized representative, requests suspension, reduction, or termination of services.

3. Time Frames

The time frames listed under Section 4. Mediation and 5. Due Process Hearing may be waived if both parties agree to an extension of time in order to conduct the Mediation or Hearing, and render a decision.

4. Mediation

A. Mediation is a voluntary process conducted by a qualified and impartial mediator

rized representative, requests suspension, reduction, or termination of services.

3. Time Frames

The time frames listed under Section 4. Mediation and 5. Due Process Hearing may be waived if both parties agree to an extension of time in order to conduct the Mediation or Hearing, and render a decision.

4. Mediation

A. Mediation is a voluntary process conducted by a qualified and impartial mediator. At any point during the mediation process, either party, or the mediator, may elect to terminate the mediation.

B. An individual must request Mediation within thirty (30) calendar days of the agency notice regarding the provision or denial of services that is in question. The request shall be in writing, and the request shall describe the complaint. The request should be sent to the Director of DVR or DBVI who will immediately forward it to a qualified mediator.

C. The mediator will commence a mediation meeting within fifteen (15) calendar days of receipt of the request, and shall be held in a location that is convenient to the parties in the dispute.

D. Mediation will be conducted in accordance with the Court Alternative Dispute Resolution Service’s (CADRES) standards on ethics and neutrality.

E. An agreement reached in the mediation process shall be set forth in a written mediation agreement, and shall be signed by both parties.

F. Discussions that occur during the mediation process shall be confidential and may not be used as evidence in any subsequent due process hearing or civil proceeding in accordance with CADRES confidentiality standards.

G. The individual may be represented at the mediation, including but not limited to, representation by the Client Assistance Program.

H. The Mediation process may not be used to deny or delay the individual’s right to pursue resolution of the dispute through a due process hearing within the specified time period.

5. Due Process Hearing

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ceeding in accordance with CADRES confidentiality standards.

G. The individual may be represented at the mediation, including but not limited to, representation by the Client Assistance Program.

H. The Mediation process may not be used to deny or delay the individual’s right to pursue resolution of the dispute through a due process hearing within the specified time period.

5. Due Process Hearing

A. Due Process Hearing is a procedure whereby an individual who is dissatisfied with any determinations concerning the provision or denial of DVR or DBVI services may seek a re-determination of agency action before an impartial hearing officer.

B. The individual must request a Due Process Hearing within thirty (30) calendar days of the agency notice regarding the provision or denial of service, if Mediation was not requested.

C. If no request for Due Process Hearing is made within thirty (30) calendar days, the agency decision is considered final.

D. The request for Due Process Hearing shall be in writing, and shall describe the complaint. Maine DVR or DBVI will accommodate an individual’s disability and offer assistance, if appropriate, in this process. The request should be sent to the Director of DVR or DBVI who will immediately forward the request to a qualified hearing officer.

E. A pre-hearing conference may be held to clarify issues and explore options for resolving grievances.

F. The Due Process Hearing shall be conducted within sixty (60) calendar days of receipt of the request for Due Process Hearing.

G. A Due Process Hearing shall be conducted by an impartial hearing officer assigned on a random basis, from the pool of qualified persons identified jointly by the Director of Maine DVR or DBVI and the State Rehabilitation Council.

H. Maine DVR or DBVI may not deny or dismiss a request for Due Process Hearing unless the individual or their representative:

(1) withdraws the request in writing; or

G. A Due Process Hearing shall be conducted by an impartial hearing officer assigned on a random basis, from the pool of qualified persons identified jointly by the Director of Maine DVR or DBVI and the State Rehabilitation Council.

H. Maine DVR or DBVI may not deny or dismiss a request for Due Process Hearing unless the individual or their representative:

(1) withdraws the request in writing; or

(2) is adjudged by the Due Process Hearing Officer to be in default for failure to appear at the hearing without good cause.

I. The Due Process Hearing shall be conducted and will include an opportunity for the individual or the individual’s representative to present witnesses and relevant evidence. A decision shall be issued in accordance with 's Administrative Procedure Act, 5 M.R.S.A. Chapter 375, subchapter IV.

J. The Due Process Hearing Officer will issue a full written report of the findings and grounds for the decision within thirty (30) days of the completion of the hearing.

K. The Hearing Officer’s decision is final unless either party brings a civil action.

6. Civil Action

Any party who disagrees with the final decision of the Due Process Hearing has the right to file a petition in Superior Court under Rule 80C of the Maine Rules of Civil Procedure.

SECTION 4. ELIGIBILITY

1. In order to be eligible for the Brain Injury Extended Support Program the individual must:

A. meet the definition of an individual with a Brain Injury found in Section 2.3 of these rules;

B. be a Vocational Rehabilitation client determined to be appropriate for supported employment/work.

C. be an individual who meets the definition of being most significantly disabled as defined in Section 5. 3. A, of the Division of Vocational Rehabilitation Rules (12-152 Chapter 1) or in Section 6, 1. A, of the Division of the Blind and Visually Impaired Rules (12-150 Chapter 101);

D. be employed in a supported employment/work setting as defined in 2.1 of this rule ;

E. require ongoing support services in order to maintain employment;

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on of being most significantly disabled as defined in Section 5. 3. A, of the Division of Vocational Rehabilitation Rules (12-152 Chapter 1) or in Section 6, 1. A, of the Division of the Blind and Visually Impaired Rules (12-150 Chapter 101);

D. be employed in a supported employment/work setting as defined in 2.1 of this rule ;

E. require ongoing support services in order to maintain employment;

F. have received written approval from the Bureau of Rehabilitation Services Regional Manager for entry into the Brain Injury Extended Support Program.

SECTION 5. SERVICES TO BE PROVIDED BY THE BRAIN INJURY EXTENDED SUPPORT PROGRAM

Funds from this program may be used to purchase those work-related support services needed for the worker in supported employment/work to maintain employment.

SECTION 6. CASE MANAGEMENT

1. It is the responsibility of the Division Director or their designee to monitor the worker receiving extended support services to ensure services are appropriate and allowable under the rules.

2. Division Director or their designee shall receive, as a minimum, quarterly reports from the provider of extended support services. Annually, in the month the worker entered into the Extended Support Program the Division Director or their designee will evaluate the worker's readiness for competitive employment without extended support.

SECTION 7. SPENDING LIMITS

The maximum annual expenditure of $7,500 for Extended Support services shall be allowed for each eligible person served in this program.

SECTION 8. TERMINATION FROM HEAD INJURY EXTENDED SUPPORT PROGRAM

An individual participating in the program may be terminated if:

1. it is agreed upon by the worker and/or their guardian, Rehabilitation Counselor, and the provider of extended support that such services, are no longer needed to maintain employment; or

2. the worker is no longer interested in receiving extended support services and the termination is requested by the worker; or

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SUPPORT PROGRAM

An individual participating in the program may be terminated if:

1. it is agreed upon by the worker and/or their guardian, Rehabilitation Counselor, and the provider of extended support that such services, are no longer needed to maintain employment; or

2. the worker is no longer interested in receiving extended support services and the termination is requested by the worker; or

3. the worker is unable to maintain employment for two (2) consecutive months.

SECTION 9. RETURING TO VOCATIONAL REHABILITATION SERVICES

Individuals can return to Vocational Rehabilitation (VR) services by reapplying forservices. Once an individual has made the decision to reapply for services, the next step is to work closely with a VR Counselor to determine their eligibility. Once the application has been received, the individual will be contacted to schedule an intake. Information is gathered at the intake regarding how the individual’s disability impedes their ability to work, and if they require vocational rehabilitation services to attain, maintain, or advance in employment. An individual may continue their current employment while in application status with VR.