Titles of Regulations: 22VAC45-70. Provision of Services in Rehabilitation Teaching (amending 22VAC45-70-10 through 22VAC45-70-80).

22VAC45-80. Provision of Independent Living Rehabilitation Services (repealing 22VAC45-80-10 through 22VAC45-80-140).

Statutory Authority: § 51.5-65 of the Code of Virginia.

Effective Date: February 16, 2022.

Agency Contact: Susan K. Davis, MS, CRC, Regulatory Coordinator, Department for the Blind and Vision Impaired, 397 Azalea Avenue, Richmond, VA 23227, telephone (804) 371-3184, or email susan.davis@dbvi.virginia.gov.

Summary:

The amendments (i) change the title of 22VAC45-70 from "Provision of Services in Rehabilitation Teaching" to "Regulations Governing the Provision of Rehabilitation Teaching and Independent Living Services" and repeal 22VAC45-80; (ii) update the agency name throughout the regulation; (iii) remove outdated definitions and add new definitions that more fully describe certain terms or that reflect rehabilitation teaching and independent living services provided under the department's Rehabilitation Teaching/Independent Living Program; (iv) add the words "independent living" throughout the regulation to clarify that those services are included along with rehabilitation teaching; (v) clarify referral and application procedures, eligibility criteria, and determination requirements; and (vi) update the name of the plan that specifies the services an individual will receive, the scope of services available to eligible individuals, and financial participation an individual may have in costs of service.

Summary of Public Comments and Agency's Response: No public comments were received by the promulgating agency.

Chapter 70

Regulations Governing the Provision of Services in Rehabilitation Teaching and Independent Living Services

Part I

Introduction

22VAC45-70-10. Definitions.

The following words and terms when used in this chapter shall have the following [ meaning meanings ] unless the context clearly indicates otherwise:

"Assessment" means the systematic evaluation or identification of the consumers' need for and ability to benefit from services.

"Blindness, legal blindness" means the condition as defined in §§ 63.1-142 and 63.1-166 of the Code of Virginia.

"Consumer" means any person undergoing an assessment or receiving a service provided by the Rehabilitation Teaching Program of the Department for the Blind and Vision Impaired.

"Blind person" means an individual who has central visual acuity of 20/200 or less in the better eye, as measured with best correction, or a limitation in the field of vision in the better eye, such that the widest diameter of the visual field subtends an angle of 20 degrees or less, as defined in § 51.5-60 of the Code of Virginia.

[ "DBVI" means the Department for the Blind and Vision Impaired. ]

"Deafblind person" means an individual:

1. a. Who has central visual acuity of 20/200 or less in the better eye with corrective lenses, or a field defect such that the peripheral diameter of visual fields subtends an angular distance no greater than 20 degrees, or a progressive visual loss having a prognosis leading to one or both of the conditions;

b. Who has a chronic hearing impairment so severe that most speech cannot be understood with optimum amplification, or a progressive hearing loss having a prognosis leading to this condition; and

c. For whom the combination of impairments described in subdivisions 1 a and 1 b of this definition cause extreme difficulty in attaining independence in daily life activities, achieving psychological adjustment, or obtaining a vocation; and

2. Who, despite the inability to be measured accurately for hearing and vision loss due to cognitive or behavioral constraints or both, can be determined through functional and performance assessments to have severe hearing and visual disabilities that cause extreme difficulty in attaining independence in daily life activities, achieving psychological adjustment, or obtaining vocational objectives.

"Department" [ or "DBVI" ] means the Department for the Blind and Vision Impaired.

"Financial needs assessment' means an assessment to consider the financial need of an individual who is applying for or receiving rehabilitation teaching and independent living services to determine the extent of the individual's participation in the costs of services.

"Independent living" means control over one's life based on the choice of acceptable options that minimize reliance on others in making decisions and performing everyday activities. This includes managing one's affairs, participating in day-to-day life in the community, fulfilling a range of social roles, making decisions that lead to self-determination, and the minimization of physical and psychological dependence on others.

[ " ] Individualized Written [ Rehabilitation Teaching/Independent Living Program ] (IWRP) [ Plan" or ("Plan") means a written program of rehabilitation teaching services identified during the assessment for each ] consumer [ individual determined eligible for services by ] this program [ the Rehabilitation Teaching/Independent Living Program. ]

"Reasonable expectation" means that rehabilitation teaching and independent living services are anticipated to significantly assist a consumer an individual to improve his ability to cope with blindness and function more independently.

"Rehabilitation teaching" means the process of guiding and instructing a blind, visually impaired consumer, or deafblind person through an individualized plan of instruction designed to develop and raise the level of adaptive coping skills and functional independence.

[ Rehabilitation Teaching/Independent Living Program Plan" or "Plan" means a written program of rehabilitation teaching services identified during the assessment for each individual determined eligible for services by the Rehabilitation Teaching/Independent Living Program. ]

"Severely visually impaired" means vision less than 20/70 in the better eye with correction or a field restricted to 70 degrees or less in the better eye.

Part II

Referral

22VAC45-70-20. Referral and application.

A. To be considered for rehabilitation teaching and independent living services, DBVI must obtain the following information must be obtained from the individual seeking services:

1. Name and address;

2. Date of birth and sex gender;

3. Disability; and

4. Date of referral.

The department DBVI shall expeditiously process persons the application of an individual who is referred for rehabilitation teaching and independent living services.

B. An DBVI shall conduct an assessment by the Department for the Blind and Vision Impaired is required of each person of the rehabilitation teaching and independent living needs of an individual who applies for rehabilitation teaching services. The assessment is limited to that information that is necessary to determine eligibility for rehabilitation teaching and independent living services consistent with 22VAC45-70-30 and to determine which rehabilitation teaching services are needed.

Part III

Eligibility

22VAC45-70-30. Eligibility for rehabilitation teaching and independent living services.

A. Eligibility shall be determined without regard to sex, sexual orientation, gender identity, race, creed, color, or national origin. No individual shall be excluded or found ineligible solely on the basis of the type of disability or on the basis of age. No residence requirement shall be imposed that excludes from services any individual who is presently in the Commonwealth.

B. To be eligible for rehabilitation teaching and independent living services, a consumer an individual must have a visual limitation that constitutes or results in a substantial impediment to personal independent functioning. A consumer, and there must be a reasonable expectation that rehabilitation teaching and independent living services will significantly assist the individual to improve his ability to cope with blindness and to function more independently. An individual has a visual limitation if one or more of the following criteria are met the individual:

1. Legal blindness Is a "blind person" as defined in 22VAC45-70-10;

2. 20/100 Has distance vision of 20/70 to 20/200 distance vision in the better eye with correcting glasses or a field limitation to 30 degrees or less in the better eye, and if the person has been unable to adjust to the loss of vision and if it is has been determined by the rehabilitation teacher that the person is to be in need of the specialized services available through the Department for the Blind and Vision Impaired's DBVI rehabilitation teaching and independent living program; or

3. Night Has night blindness or a rapidly progressive eye condition which, in the opinion of a qualified ophthalmologist or optometrist, will reduce the distance vision to 20/200 or less.

B. A reasonable expectation that rehabilitation teaching services will significantly assist the consumer to improve his ability to cope with blindness and to function more independently.

22VAC45-70-40. Eligibility determination.

Prior to or simultaneously with acceptance of a consumer an individual for rehabilitation teaching and independent living services, there shall be a determination of eligibility; a case narrative shall state the basis for the visual eligibility determination and a reasonable expectation that rehabilitation teaching will significantly and independent living services shall assist the consumer in achieving or maintaining functional independence individual to improve his ability to cope with blindness and to function more independently. When a consumer an individual is determined ineligible for rehabilitation teaching services and independent living services, the rehabilitation teacher shall inform the consumer individual of the ineligibility determination, stating the reason or reasons. This may be done during a personal contact or by a letter.

22VAC45-70-60. The Individualized Written Rehabilitation Teaching/Independent Living Program (IWRP) Plan.

Initial plan development.

1. The IWRP Plan shall specify the rehabilitation teaching and independent living services that the consumer individual and DBVI instructor rehabilitation teacher jointly determine are necessary to raise increase the individual's level of adaptive coping skills and functional independence.

2. The IWRP Plan shall be initiated after determination of eligibility and periodically updated to include additional rehabilitation teaching and independent living services that are needed by the consumer individual.

3. Rehabilitation teaching and independent living services shall be provided in accordance with IWRP the Plan.

22VAC45-70-70. Scope of rehabilitation teaching and independent living services.

Services provided through the rehabilitation teaching services and independent living program may include:

1. Counseling to determine the consumer's individual's need for specific rehabilitation teaching and independent living services.

2. Referral to and information regarding resources and programs that, internal and external to DBVI, which might benefit the consumer individual.

3. Counseling to assist the consumer individual to cope with visual vision loss.

4. Provision of low vision services in accordance with the Regulations Governing Low Vision, 22VAC45-110.

5. Instruction in the following areas:

a. Personal management skills or activities of daily living;

b. Home management skills;

c. Communication skills, including reading and writing braille, typing, script writing, and use of electronic equipment and technology;

d. Other appropriate adaptive coping skills, i.e., to facilitate leisure and recreational activities; and

e. Information and instruction in the acquisition of and use of adaptive equipment.

Part V

Financial Participation

22VAC45-70-80. Financial participation in cost of services.

A. The Department for the Blind and Vision Impaired DBVI has elected to uniformly apply a financial needs assessment for persons receiving purchased rehabilitation teaching and independent living services and goods in the Commonwealth. Purchased services and goods may be provided at no cost to the recipient who is legally a blind person if the family's income is less than 100% 80% of the federally estimated median income for Virginia, and if the family's assets are less than 50% of the federally estimated median income as determined by the [ United States U.S. ] Department of Health and Human Services, Family Support Administration. The Department for the Blind and Vision Impaired will DBVI shall review and change its financial participation levels to match the above-referenced estimated median income level every third year annually.

B. There is shall be no financial participation in cost of services required for the assessment, counseling, low vision exams, information and referral, and instructional services provided through the rehabilitation teaching services and independent living program.

C. Consumers must be both legally blind and demonstrate financial need as determined by the financial needs assessment in order to receive any purchased services or goods other than a low vision exam. D. Allowable deductions from income.

1. Expenses that may be deducted from family income on the financial needs assessment are unusual medical expenses and the education of a consumer the individual or family member to attend a private or public educational facility. Medical expenses such as, including routine doctors' visits and hospital insurance premiums, may not be deducted.

2. When the consumer's individual's gross family income, liquid assets, or both, exceed the financial eligibility need requirement after allowable deductions have been considered, the consumer individual and his family are required to apply the excess toward the cost of those services provided by rehabilitation teaching and independent living services for which financial need is considered.